How much rates vary
Facilitymedian $1,288 · 10th to 90th $437 to $3,715Professionalmedian $105 · 10th to 90th $17 to $871
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 $691.83 Median $2,290.87 Typical High $6,918.31 | Facility | None | $691.83 | $2,290.87 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $100.00 Typical High $575.44 | Professional | None | $87.10 | $100.00 | $575.44 |
BCBS Texas Setting Facility Modifier None Typical Low $758.58 Median $1,445.44 Typical High $3,162.28 | Facility | None | $758.58 | $1,445.44 | $3,162.28 |
BCBS Texas Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $169.82 | Professional | None | $97.72 | $123.03 | $169.82 |
Christus Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $630.96 Typical High $1,412.54 | Facility | None | $436.52 | $630.96 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $128.82 Typical High $213.80 | Professional | None | $112.20 | $128.82 | $213.80 |
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 $870.96 Median $977.24 Typical High $977.24 | Professional | None | $870.96 | $977.24 | $977.24 |
Moda Health Setting Facility Modifier None Typical Low $114.82 Median $1,778.28 Typical High $5,248.07 | Facility | None | $114.82 | $1,778.28 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $87.10 Median $100.00 Typical High $177.83 | Professional | None | $87.10 | $100.00 | $177.83 |
Molina Setting Professional Modifier None Typical Low $14.13 Median $77.62 Typical High $109.65 | Professional | None | $14.13 | $77.62 | $109.65 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $707.95 Typical High $3,801.89 | Facility | None | $338.84 | $707.95 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $213.80 | Professional | None | $112.20 | $131.83 | $213.80 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,288.25 Typical High $3,235.94 | Facility | None | $389.05 | $1,288.25 | $3,235.94 |
United Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $186.21 | Professional | None | $81.28 | $117.49 | $186.21 |
Wellpoint Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
11 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 $43.65 Median $47.86 Typical High $54.95 | Professional | 52 · Reduced service | $43.65 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $19.05 Typical High $21.88 | Professional | 53 · Discontinued | $17.38 | $19.05 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $70.79 Typical High $83.18 | Professional | 54 · Surgery only | $66.07 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $14.45 Typical High $16.60 | Professional | 55 · Aftercare only | $13.18 | $14.45 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.55 Typical High $10.96 | Professional | 56 · Pre-op care only | $8.71 | $9.55 | $10.96 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 79 · Unrelated procedure after surgery | $95.50 | $95.50 | $95.50 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $47.86 Typical High $54.95 | Professional | 52 · Reduced service | $43.65 | $47.86 | $54.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $19.05 Typical High $21.88 | Professional | 53 · Discontinued | $17.38 | $19.05 | $21.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $70.79 Typical High $83.18 | Professional | 54 · Surgery only | $66.07 | $70.79 | $83.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $14.45 Typical High $16.60 | Professional | 55 · Aftercare only | $13.18 | $14.45 | $16.60 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.55 Typical High $10.96 | Professional | 56 · Pre-op care only | $8.71 | $9.55 | $10.96 |
Where Texas sits
The same service costs 8.3 times more in New York than in Montana. 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.
Physician feeFacility fee
NY $2,848MT $344
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.