How much rates vary
Facilitymedian $1,023 · 10th to 90th $380 to $3,890Professionalmedian $126 · 10th to 90th $22 to $794
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 $91.20 Median $102.33 Typical High $891.25 | Professional | None | $91.20 | $102.33 | $891.25 |
BCBS Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $346.74 | Professional | None | $104.71 | $141.25 | $346.74 |
Christus Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $512.86 Typical High $1,412.54 | Facility | None | $380.19 | $512.86 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $190.55 | Professional | None | $114.82 | $134.90 | $190.55 |
Lucent Health Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,000.00 | Professional | None | $794.33 | $794.33 | $1,000.00 |
Moda Health Setting Facility Modifier None Typical Low $112.20 Median $1,737.80 Typical High $5,495.41 | Facility | None | $112.20 | $1,737.80 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $91.20 Median $102.33 Typical High $181.97 | Professional | None | $91.20 | $102.33 | $181.97 |
Molina Setting Professional Modifier None Typical Low $19.05 Median $104.71 Typical High $144.54 | Professional | None | $19.05 | $104.71 | $144.54 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $549.54 Typical High $3,801.89 | Facility | None | $338.84 | $549.54 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $190.55 | Professional | None | $114.82 | $138.04 | $190.55 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,230.27 Typical High $3,235.94 | Facility | None | $389.05 | $1,230.27 | $3,235.94 |
United Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $181.97 | Professional | None | $89.13 | $120.23 | $181.97 |
Wellpoint Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
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 $45.71 Median $50.12 Typical High $58.88 | Professional | 52 · Reduced service | $45.71 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $20.42 Typical High $23.44 | Professional | 53 · Discontinued | $18.62 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $75.86 Typical High $89.13 | Professional | 54 · Surgery only | $69.18 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.14 Typical High $17.78 | Professional | 55 · Aftercare only | $13.80 | $15.14 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.00 Typical High $11.75 | Professional | 56 · Pre-op care only | $9.12 | $10.00 | $11.75 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $50.12 Typical High $58.88 | Professional | 52 · Reduced service | $45.71 | $50.12 | $58.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.95 Typical High $23.44 | Professional | 53 · Discontinued | $18.62 | $19.95 | $23.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $75.86 Typical High $89.13 | Professional | 54 · Surgery only | $69.18 | $75.86 | $89.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.14 Typical High $17.78 | Professional | 55 · Aftercare only | $13.80 | $15.14 | $17.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.00 Typical High $11.75 | Professional | 56 · Pre-op care only | $9.12 | $10.00 | $11.75 |
Where Texas sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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· 46th of 51
$138
AK $513KY $117
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.