How much rates vary
Facilitymedian $141 · 10th to 90th $38 to $3,236Professionalmedian $60 · 10th to 90th $37 to $912
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 $67.61 Median $3,715.35 Typical High $9,120.11 | Facility | None | $67.61 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $63.10 Typical High $75.86 | Professional | None | $47.86 | $63.10 | $75.86 |
BCBS Texas Setting Facility Modifier None Typical Low $31.62 Median $52.48 Typical High $724.44 | Facility | None | $31.62 | $52.48 | $724.44 |
BCBS Texas Setting Professional Modifier None Typical Low $43.65 Median $58.88 Typical High $77.62 | Professional | None | $43.65 | $58.88 | $77.62 |
Christus Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $45.71 Typical High $79.43 | Facility | None | $32.36 | $45.71 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $58.88 Typical High $85.11 | Professional | None | $45.71 | $58.88 | $85.11 |
Lucent Health Setting Professional Modifier None Typical Low $912.01 Median $1,905.46 Typical High $1,905.46 | Professional | None | $912.01 | $1,905.46 | $1,905.46 |
Moda Health Setting Facility Modifier None Typical Low $47.86 Median $707.95 Typical High $5,248.07 | Facility | None | $47.86 | $707.95 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $47.86 Median $63.10 Typical High $75.86 | Professional | None | $47.86 | $63.10 | $75.86 |
Molina Setting Professional Modifier None Typical Low $10.00 Median $53.70 Typical High $74.13 | Professional | None | $10.00 | $53.70 | $74.13 |
Providence Setting Facility Modifier None Typical Low $36.31 Median $50.12 Typical High $104.71 | Facility | None | $36.31 | $50.12 | $104.71 |
Providence Setting Professional Modifier None Typical Low $45.71 Median $58.88 Typical High $85.11 | Professional | None | $45.71 | $58.88 | $85.11 |
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 $42.66 Median $56.23 Typical High $85.11 | Professional | None | $42.66 | $56.23 | $85.11 |
Wellpoint Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $61.66 | Professional | None | $60.26 | $61.66 | $61.66 |
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 $23.99 Median $31.62 Typical High $38.02 | Professional | 52 · Reduced service | $23.99 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $12.59 Typical High $15.49 | Professional | 53 · Discontinued | $9.55 | $12.59 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $46.77 Typical High $57.54 | Professional | 54 · Surgery only | $35.48 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $9.33 Typical High $11.48 | Professional | 55 · Aftercare only | $7.08 | $9.33 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.31 Typical High $7.59 | Professional | 56 · Pre-op care only | $4.79 | $6.31 | $7.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $31.62 Typical High $38.02 | Professional | 52 · Reduced service | $23.99 | $31.62 | $38.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $12.59 Typical High $15.49 | Professional | 53 · Discontinued | $9.55 | $12.59 | $15.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $46.77 Typical High $57.54 | Professional | 54 · Surgery only | $35.48 | $46.77 | $57.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $9.33 Typical High $11.48 | Professional | 55 · Aftercare only | $7.08 | $9.33 | $11.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.31 Typical High $7.59 | Professional | 56 · Pre-op care only | $4.79 | $6.31 | $7.59 |
Where Texas sits
The same service costs 3.7 times more in Alaska than in Florida. 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· 42nd of 51
$61.66
AK $191FL $51.29
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.