How much rates vary
Facilitymedian $468 · 10th to 90th $63 to $3,715Professionalmedian $89 · 10th to 90th $18 to $661
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $107.15 Median $3,715.35 Typical High $9,120.11 | Facility | None | $107.15 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $81.28 Typical High $107.15 | Professional | None | $52.48 | $81.28 | $107.15 |
BCBS Texas Setting Professional Modifier None Typical Low $53.70 Median $89.13 Typical High $177.83 | Professional | None | $53.70 | $89.13 | $177.83 |
Christus Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $72.44 Typical High $1,412.54 | Facility | None | $51.29 | $72.44 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $91.20 Typical High $138.04 | Professional | None | $57.54 | $91.20 | $138.04 |
Lucent Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $794.33 | Professional | None | $660.69 | $660.69 | $794.33 |
Moda Health Setting Facility Modifier None Typical Low $58.88 Median $524.81 Typical High $5,248.07 | Facility | None | $58.88 | $524.81 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $52.48 Median $83.18 Typical High $109.65 | Professional | None | $52.48 | $83.18 | $109.65 |
Molina Setting Professional Modifier None Typical Low $14.45 Median $79.43 Typical High $107.15 | Professional | None | $14.45 | $79.43 | $107.15 |
Providence Setting Facility Modifier None Typical Low $57.54 Median $107.15 Typical High $3,801.89 | Facility | None | $57.54 | $107.15 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $57.54 Median $91.20 Typical High $138.04 | Professional | None | $57.54 | $91.20 | $138.04 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $50.12 Median $77.62 Typical High $123.03 | Professional | None | $50.12 | $77.62 | $123.03 |
Wellpoint Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
10 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $38.90 Typical High $53.70 | Professional | 52 · Reduced service | $26.30 | $38.90 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $15.49 Typical High $21.38 | Professional | 53 · Discontinued | $10.47 | $15.49 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $58.88 Typical High $79.43 | Professional | 54 · Surgery only | $39.81 | $58.88 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $11.75 Typical High $15.85 | Professional | 55 · Aftercare only | $7.94 | $11.75 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $7.76 Typical High $10.72 | Professional | 56 · Pre-op care only | $5.25 | $7.76 | $10.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $39.81 Typical High $53.70 | Professional | 52 · Reduced service | $26.30 | $39.81 | $53.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $15.85 Typical High $21.38 | Professional | 53 · Discontinued | $10.47 | $15.85 | $21.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $60.26 Typical High $79.43 | Professional | 54 · Surgery only | $39.81 | $60.26 | $79.43 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $12.02 Typical High $15.85 | Professional | 55 · Aftercare only | $7.94 | $12.02 | $15.85 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $7.94 Typical High $10.72 | Professional | 56 · Pre-op care only | $5.25 | $7.94 | $10.72 |
Where Texas sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Texas· 39th of 51
$91.20
WI $240DC $77.62
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.