How much rates vary
Facilitymedian $794 · 10th to 90th $263 to $3,090Professionalmedian $182 · 10th to 90th $135 to $2,042
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 $660.69 Median $2,238.72 Typical High $6,918.31 | Facility | None | $660.69 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $138.04 Typical High $173.78 | Professional | None | $131.83 | $138.04 | $173.78 |
BCBS Texas Setting Facility Modifier None Typical Low $194.98 Median $676.08 Typical High $1,905.46 | Facility | None | $194.98 | $676.08 | $1,905.46 |
BCBS Texas Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Christus Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $660.69 Typical High $1,479.11 | Facility | None | $457.09 | $660.69 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $165.96 Typical High $251.19 | Professional | None | $147.91 | $165.96 | $251.19 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,905.46 | $2,041.74 | $2,041.74 |
Moda Health Setting Facility Modifier None Typical Low $208.93 Median $1,905.46 Typical High $5,495.41 | Facility | None | $208.93 | $1,905.46 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $134.90 Median $141.25 Typical High $173.78 | Professional | None | $134.90 | $141.25 | $173.78 |
Providence Setting Facility Modifier None Typical Low $426.58 Median $741.31 Typical High $3,801.89 | Facility | None | $426.58 | $741.31 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $147.91 Median $165.96 Typical High $245.47 | Professional | None | $147.91 | $165.96 | $245.47 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,288.25 Typical High $3,090.30 | Facility | None | $389.05 | $1,288.25 | $3,090.30 |
United Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $223.87 | Professional | None | $107.15 | $147.91 | $223.87 |
Wellpoint Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
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 $66.07 Median $70.79 Typical High $85.11 | Professional | 52 · Reduced service | $66.07 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $28.84 Typical High $33.88 | Professional | 53 · Discontinued | $26.30 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $107.15 Typical High $128.82 | Professional | 54 · Surgery only | $97.72 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $21.38 Typical High $25.70 | Professional | 55 · Aftercare only | $19.95 | $21.38 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.13 Typical High $16.98 | Professional | 56 · Pre-op care only | $13.18 | $14.13 | $16.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $72.44 Typical High $85.11 | Professional | 52 · Reduced service | $66.07 | $72.44 | $85.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $28.84 Typical High $33.88 | Professional | 53 · Discontinued | $26.30 | $28.84 | $33.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $107.15 Typical High $128.82 | Professional | 54 · Surgery only | $97.72 | $107.15 | $128.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $21.88 Typical High $25.70 | Professional | 55 · Aftercare only | $19.95 | $21.88 | $25.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.45 Typical High $16.98 | Professional | 56 · Pre-op care only | $13.18 | $14.45 | $16.98 |
Where Texas sits
The same service costs 4.3 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· 3rd of 51
$537
AK $603NY $141
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.