How much rates vary
Facilitymedian $288 · 10th to 90th $123 to $2,570Professionalmedian $3,890 · 10th to 90th $417 to $4,365
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 $851.14 Median $2,754.23 Typical High $6,918.31 | Facility | None | $851.14 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $691.83 | Professional | None | $407.38 | $524.81 | $691.83 |
BCBS Texas Setting Facility Modifier None Typical Low $109.65 Median $213.80 Typical High $676.08 | Facility | None | $109.65 | $213.80 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,258.93 Typical High $2,691.53 | Facility | None | $630.96 | $1,258.93 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $724.44 | Professional | None | $478.63 | $537.03 | $724.44 |
Lucent Health Setting Professional Modifier None Typical Low $3,890.45 Median $4,365.16 Typical High $4,365.16 | Professional | None | $3,890.45 | $4,365.16 | $4,365.16 |
Moda Health Setting Facility Modifier None Typical Low $602.56 Median $2,511.89 Typical High $6,165.95 | Facility | None | $602.56 | $2,511.89 | $6,165.95 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $562.34 | Professional | None | $407.38 | $512.86 | $562.34 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $416.87 Median $575.44 Typical High $758.58 | Facility | None | $416.87 | $575.44 | $758.58 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $812.83 | Professional | None | $60.26 | $79.43 | $812.83 |
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 |
Wellpoint Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
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 $229.09 Typical High $263.03 | Professional | 52 · Reduced service | $204.17 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $91.20 Typical High $104.71 | Professional | 53 · Discontinued | $81.28 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $338.84 Typical High $398.11 | Professional | 54 · Surgery only | $309.03 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $61.66 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $45.71 Typical High $52.48 | Professional | 56 · Pre-op care only | $40.74 | $45.71 | $52.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $218.78 Typical High $263.03 | Professional | 52 · Reduced service | $204.17 | $218.78 | $263.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $87.10 Typical High $104.71 | Professional | 53 · Discontinued | $81.28 | $87.10 | $104.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $331.13 Typical High $398.11 | Professional | 54 · Surgery only | $302.00 | $331.13 | $398.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $66.07 Typical High $79.43 | Professional | 55 · Aftercare only | $60.26 | $66.07 | $79.43 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $43.65 Typical High $52.48 | Professional | 56 · Pre-op care only | $40.74 | $43.65 | $52.48 |
Where Texas sits
The same service costs 134.9 times more in Oklahoma than in Hawaii. 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· 34th of 51
$550
OK $3,981HI $29.51
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.