How much rates vary
Facilitymedian $195 · 10th to 90th $8 to $2,188Professionalmedian $15 · 10th to 90th $11 to $295
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 $13.49 Median $22.39 Typical High $93.33 | Facility | None | $13.49 | $22.39 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $13.80 Typical High $18.20 | Professional | None | $11.22 | $13.80 | $18.20 |
BCBS Texas Setting Professional Modifier None Typical Low $11.48 Median $16.98 Typical High $31.62 | Professional | None | $11.48 | $16.98 | $31.62 |
Christus Setting Facility Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Facility | None | $7.41 | $7.41 | $7.41 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $8.71 Typical High $1,412.54 | Facility | None | $6.17 | $8.71 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $15.85 Typical High $26.30 | Professional | None | $12.02 | $15.85 | $26.30 |
Lucent Health Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Moda Health Setting Facility Modifier None Typical Low $10.96 Median $17.38 Typical High $85.11 | Facility | None | $10.96 | $17.38 | $85.11 |
Moda Health Setting Professional Modifier None Typical Low $11.22 Median $13.80 Typical High $18.62 | Professional | None | $11.22 | $13.80 | $18.62 |
Providence Setting Facility Modifier None Typical Low $7.08 Median $18.62 Typical High $3,801.89 | Facility | None | $7.08 | $18.62 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $12.02 Median $15.85 Typical High $26.30 | Professional | None | $12.02 | $15.85 | $26.30 |
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 $10.72 Median $14.79 Typical High $25.12 | Professional | None | $10.72 | $14.79 | $25.12 |
Wellpoint Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
20 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 Facility Modifier 52 · Reduced service Typical Low $6.76 Median $11.22 Typical High $46.77 | Facility | 52 · Reduced service | $6.76 | $11.22 | $46.77 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.69 Median $4.47 Typical High $19.05 | Facility | 53 · Discontinued | $2.69 | $4.47 | $19.05 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $10.00 Median $17.38 Typical High $70.79 | Facility | 54 · Surgery only | $10.00 | $17.38 | $70.79 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.00 Median $3.31 Typical High $14.13 | Facility | 55 · Aftercare only | $2.00 | $3.31 | $14.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.35 Median $2.24 Typical High $9.33 | Facility | 56 · Pre-op care only | $1.35 | $2.24 | $9.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.62 Median $6.92 Typical High $8.71 | Professional | 52 · Reduced service | $5.62 | $6.92 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.75 Typical High $3.47 | Professional | 53 · Discontinued | $2.24 | $2.75 | $3.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.32 Median $10.23 Typical High $12.88 | Professional | 54 · Surgery only | $8.32 | $10.23 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $2.04 Typical High $2.57 | Professional | 55 · Aftercare only | $1.66 | $2.04 | $2.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.38 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.12 | $1.38 | $1.74 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $7.08 Median $11.22 Typical High $50.12 | Facility | 52 · Reduced service | $7.08 | $11.22 | $50.12 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $2.82 Median $4.47 Typical High $19.95 | Facility | 53 · Discontinued | $2.82 | $4.47 | $19.95 |
Moda Health Setting Facility Modifier 54 · Surgery only Typical Low $10.47 Median $16.60 Typical High $75.86 | Facility | 54 · Surgery only | $10.47 | $16.60 | $75.86 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $2.09 Median $3.31 Typical High $15.14 | Facility | 55 · Aftercare only | $2.09 | $3.31 | $15.14 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $1.41 Median $2.24 Typical High $10.00 | Facility | 56 · Pre-op care only | $1.41 | $2.24 | $10.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.62 Median $6.92 Typical High $8.71 | Professional | 52 · Reduced service | $5.62 | $6.92 | $8.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.75 Typical High $3.47 | Professional | 53 · Discontinued | $2.24 | $2.75 | $3.47 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $8.32 Median $10.23 Typical High $12.88 | Professional | 54 · Surgery only | $8.32 | $10.23 | $12.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $2.04 Typical High $2.57 | Professional | 55 · Aftercare only | $1.66 | $2.04 | $2.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.38 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.12 | $1.38 | $1.74 |
Where Texas sits
The same service costs 3.5 times more in Alaska than in New York. 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· 43rd of 51
$16.22
AK $48.98NY $13.80
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.