How much rates vary
Facilitymedian $3,715 · 10th to 90th $617 to $12,589Professionalmedian $708 · 10th to 90th $240 to $5,012
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 $2,398.83 Typical High $6,918.31 | Facility | None | $691.83 | $2,398.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $691.83 | Professional | None | $512.86 | $575.44 | $691.83 |
BCBS Texas Setting Facility Modifier None Typical Low $234.42 Median $6,025.60 Typical High $19,498.45 | Facility | None | $234.42 | $6,025.60 | $19,498.45 |
BCBS Texas Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $3,548.13 Typical High $6,760.83 | Facility | None | $660.69 | $3,548.13 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $933.25 | Professional | None | $562.34 | $707.95 | $933.25 |
Lucent Health Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $5,011.87 | Professional | None | $4,365.16 | $4,365.16 | $5,011.87 |
Moda Health Setting Facility Modifier None Typical Low $562.34 Median $1,778.28 Typical High $5,495.41 | Facility | None | $562.34 | $1,778.28 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $645.65 | Professional | None | $512.86 | $575.44 | $645.65 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $89.13 Typical High $512.86 | Professional | None | $77.62 | $89.13 | $512.86 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $6,760.83 Typical High $12,589.25 | Facility | None | $630.96 | $6,760.83 | $12,589.25 |
Providence Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $933.25 | Professional | None | $562.34 | $707.95 | $933.25 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $4,897.79 Typical High $10,471.29 | Facility | None | $1,737.80 | $4,897.79 | $10,471.29 |
United Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $457.09 | Professional | None | $223.87 | $309.03 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
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 $257.04 Median $281.84 Typical High $323.59 | Professional | 52 · Reduced service | $257.04 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $114.82 Typical High $128.82 | Professional | 53 · Discontinued | $102.33 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $426.58 Typical High $478.63 | Professional | 54 · Surgery only | $389.05 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $85.11 Typical High $97.72 | Professional | 55 · Aftercare only | $77.62 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $57.54 Typical High $64.57 | Professional | 56 · Pre-op care only | $51.29 | $57.54 | $64.57 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $281.84 Typical High $316.23 | Professional | 52 · Reduced service | $257.04 | $281.84 | $316.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $114.82 Typical High $128.82 | Professional | 53 · Discontinued | $102.33 | $114.82 | $128.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $426.58 Typical High $478.63 | Professional | 54 · Surgery only | $389.05 | $426.58 | $478.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $85.11 Typical High $95.50 | Professional | 55 · Aftercare only | $77.62 | $85.11 | $95.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $57.54 Typical High $64.57 | Professional | 56 · Pre-op care only | $51.29 | $57.54 | $64.57 |
Where Texas sits
The same service costs 10.0 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· 19th of 51
$776
AK $2,455KY $245
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.