How much rates vary
Facilitymedian $1,023 · 10th to 90th $55 to $3,715Professionalmedian $32 · 10th to 90th $26 to $513
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 $575.44 Median $2,238.72 Typical High $6,918.31 | Facility | None | $575.44 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $29.51 Typical High $41.69 | Professional | None | $27.54 | $29.51 | $41.69 |
BCBS Texas Setting Professional Modifier None Typical Low $24.55 Median $30.90 Typical High $40.74 | Professional | None | $24.55 | $30.90 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $1,584.89 Typical High $2,691.53 | Facility | None | $380.19 | $1,584.89 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $29.51 Typical High $39.81 | Professional | None | $25.70 | $29.51 | $39.81 |
Lucent Health Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $794.33 | Professional | None | $512.86 | $794.33 | $794.33 |
Moda Health Setting Facility Modifier None Typical Low $28.18 Median $1,000.00 Typical High $4,677.35 | Facility | None | $28.18 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $27.54 Median $29.51 Typical High $39.81 | Professional | None | $27.54 | $29.51 | $39.81 |
Molina Setting Professional Modifier None Typical Low $22.91 Median $23.99 Typical High $23.99 | Professional | None | $22.91 | $23.99 | $23.99 |
Providence Setting Facility Modifier None Typical Low $28.18 Median $398.11 Typical High $2,691.53 | Facility | None | $28.18 | $398.11 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $25.70 Median $29.51 Typical High $39.81 | Professional | None | $25.70 | $29.51 | $39.81 |
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 |
United Setting Professional Modifier None Typical Low $22.39 Median $29.51 Typical High $40.74 | Professional | None | $22.39 | $29.51 | $40.74 |
Wellpoint Setting Professional Modifier None Typical Low $28.18 Median $28.84 Typical High $28.84 | Professional | None | $28.18 | $28.84 | $28.84 |
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 $13.80 Median $14.79 Typical High $19.05 | Professional | 52 · Reduced service | $13.80 | $14.79 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $6.03 Typical High $7.76 | Professional | 53 · Discontinued | $5.50 | $6.03 | $7.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.42 Median $22.39 Typical High $28.84 | Professional | 54 · Surgery only | $20.42 | $22.39 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.47 Typical High $5.75 | Professional | 55 · Aftercare only | $4.07 | $4.47 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.95 Typical High $3.89 | Professional | 56 · Pre-op care only | $2.75 | $2.95 | $3.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13.80 Median $14.79 Typical High $19.05 | Professional | 52 · Reduced service | $13.80 | $14.79 | $19.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $6.03 Typical High $7.76 | Professional | 53 · Discontinued | $5.50 | $6.03 | $7.76 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $20.42 Median $22.39 Typical High $28.84 | Professional | 54 · Surgery only | $20.42 | $22.39 | $28.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.47 Typical High $5.75 | Professional | 55 · Aftercare only | $4.07 | $4.47 | $5.75 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.95 Typical High $3.89 | Professional | 56 · Pre-op care only | $2.75 | $2.95 | $3.89 |
Where Texas sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 38th of 51
$33.11
AK $110NJ $26.92
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.