How much rates vary
Facilitymedian $631 · 10th to 90th $186 to $3,715Professionalmedian $490 · 10th to 90th $78 to $4,074
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 $2,398.83 Typical High $6,918.31 | Facility | None | $660.69 | $2,398.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $1,548.82 | Professional | None | $407.38 | $489.78 | $1,548.82 |
BCBS Texas Setting Facility Modifier None Typical Low $275.42 Median $501.19 Typical High $1,412.54 | Facility | None | $275.42 | $501.19 | $1,412.54 |
BCBS Texas Setting Professional Modifier None Typical Low $416.87 Median $616.60 Typical High $977.24 | Professional | None | $416.87 | $616.60 | $977.24 |
Christus Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $239.88 Typical High $1,412.54 | Facility | None | $169.82 | $239.88 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $851.14 | Professional | None | $489.78 | $512.86 | $851.14 |
Lucent Health Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $4,073.80 | Professional | None | $3,630.78 | $3,630.78 | $4,073.80 |
Moda Health Setting Facility Modifier None Typical Low $467.74 Median $1,819.70 Typical High $5,623.41 | Facility | None | $467.74 | $1,819.70 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $691.83 | Professional | None | $407.38 | $489.78 | $691.83 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $371.54 Typical High $501.19 | Professional | None | $67.61 | $371.54 | $501.19 |
Providence Setting Facility Modifier None Typical Low $190.55 Median $446.68 Typical High $3,801.89 | Facility | None | $190.55 | $446.68 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $851.14 | Professional | None | $489.78 | $512.86 | $851.14 |
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 $407.38 Median $549.54 Typical High $831.76 | Professional | None | $407.38 | $549.54 | $831.76 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $204.17 Median $223.87 Typical High $257.04 | Professional | 52 · Reduced service | $204.17 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $89.13 Typical High $102.33 | Professional | 53 · Discontinued | $81.28 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $338.84 Typical High $380.19 | Professional | 54 · Surgery only | $302.00 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $67.61 Typical High $75.86 | Professional | 55 · Aftercare only | $60.26 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $44.67 Typical High $51.29 | Professional | 56 · Pre-op care only | $40.74 | $44.67 | $51.29 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $223.87 Typical High $257.04 | Professional | 52 · Reduced service | $199.53 | $223.87 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $89.13 Typical High $102.33 | Professional | 53 · Discontinued | $79.43 | $89.13 | $102.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $338.84 Typical High $380.19 | Professional | 54 · Surgery only | $302.00 | $338.84 | $380.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $67.61 Typical High $75.86 | Professional | 55 · Aftercare only | $60.26 | $67.61 | $75.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $44.67 Typical High $51.29 | Professional | 56 · Pre-op care only | $39.81 | $44.67 | $51.29 |
Where Texas sits
The same service costs 3.2 times more in Alaska than in Arkansas. 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· 47th of 51
$501
AK $1,380AR $427
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.