How much rates vary
Facilitymedian $603 · 10th to 90th $151 to $6,166Professionalmedian $132 · 10th to 90th $22 to $891
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 $724.44 Median $3,715.35 Typical High $9,120.11 | Facility | None | $724.44 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $147.91 | Professional | None | $102.33 | $114.82 | $147.91 |
BCBS Texas Setting Facility Modifier None Typical Low $134.90 Median $251.19 Typical High $1,737.80 | Facility | None | $134.90 | $251.19 | $1,737.80 |
BCBS Texas Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $199.53 | Professional | None | $114.82 | $144.54 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,479.11 Typical High $2,691.53 | Facility | None | $537.03 | $1,479.11 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $213.80 | Professional | None | $128.82 | $151.36 | $213.80 |
Lucent Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,047.13 | Professional | None | $891.25 | $891.25 | $1,047.13 |
Moda Health Setting Facility Modifier None Typical Low $112.20 Median $1,819.70 Typical High $6,918.31 | Facility | None | $112.20 | $1,819.70 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $165.96 | Professional | None | $102.33 | $114.82 | $165.96 |
Molina Setting Professional Modifier None Typical Low $19.05 Median $107.15 Typical High $144.54 | Professional | None | $19.05 | $107.15 | $144.54 |
Providence Setting Facility Modifier None Typical Low $117.49 Median $660.69 Typical High $2,691.53 | Facility | None | $117.49 | $660.69 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $213.80 | Professional | None | $128.82 | $151.36 | $213.80 |
United Setting Facility Modifier None Typical Low $407.38 Median $2,137.96 Typical High $8,912.51 | Facility | None | $407.38 | $2,137.96 | $8,912.51 |
United Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $204.17 | Professional | None | $100.00 | $134.90 | $204.17 |
Wellpoint Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
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 $51.29 Median $54.95 Typical High $64.57 | Professional | 52 · Reduced service | $51.29 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $22.39 Typical High $25.70 | Professional | 53 · Discontinued | $20.42 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $83.18 Typical High $97.72 | Professional | 54 · Surgery only | $75.86 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.60 Typical High $19.50 | Professional | 55 · Aftercare only | $15.14 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.96 Typical High $12.88 | Professional | 56 · Pre-op care only | $10.23 | $10.96 | $12.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $54.95 Typical High $66.07 | Professional | 52 · Reduced service | $51.29 | $54.95 | $66.07 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $22.39 Typical High $26.30 | Professional | 53 · Discontinued | $20.42 | $22.39 | $26.30 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $83.18 Typical High $100.00 | Professional | 54 · Surgery only | $75.86 | $83.18 | $100.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.60 Typical High $19.95 | Professional | 55 · Aftercare only | $15.14 | $16.60 | $19.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.96 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.23 | $10.96 | $13.18 |
Where Texas sits
The same service costs 3.9 times more in Alaska than in Utah. 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
$141
AK $513UT $132
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.