How much rates vary
Facilitymedian $1,820 · 10th to 90th $282 to $10,715Professionalmedian $191 · 10th to 90th $29 to $1,413
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 $114.82 Median $147.91 Typical High $245.47 | Professional | None | $114.82 | $147.91 | $245.47 |
BCBS Texas Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $645.65 | Professional | None | $162.18 | $229.09 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,513.56 | Facility | None | $891.25 | $1,096.48 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $309.03 | Professional | None | $190.55 | $223.87 | $309.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,412.54 | Professional | None | $1,148.15 | $1,148.15 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $158.49 Median $1,819.70 Typical High $6,918.31 | Facility | None | $158.49 | $1,819.70 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $245.47 | Professional | None | $114.82 | $147.91 | $245.47 |
Molina Setting Professional Modifier None Typical Low $24.55 Median $134.90 Typical High $186.21 | Professional | None | $24.55 | $134.90 | $186.21 |
Providence Setting Facility Modifier None Typical Low $190.55 Median $1,318.26 Typical High $251,188.64 | Facility | None | $190.55 | $1,318.26 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $316.23 | Professional | None | $186.21 | $223.87 | $316.23 |
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 $147.91 Median $204.17 Typical High $302.00 | Professional | None | $147.91 | $204.17 | $302.00 |
Wellpoint Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
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 $57.54 Median $74.13 Typical High $93.33 | Professional | 52 · Reduced service | $57.54 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $29.51 Typical High $37.15 | Professional | 53 · Discontinued | $22.91 | $29.51 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $112.20 Typical High $141.25 | Professional | 54 · Surgery only | $87.10 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $22.39 Typical High $28.18 | Professional | 55 · Aftercare only | $17.38 | $22.39 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.79 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.48 | $14.79 | $18.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $74.13 Typical High $93.33 | Professional | 52 · Reduced service | $57.54 | $74.13 | $93.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $29.51 Typical High $37.15 | Professional | 53 · Discontinued | $22.91 | $29.51 | $37.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $112.20 Typical High $141.25 | Professional | 54 · Surgery only | $87.10 | $112.20 | $141.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $22.39 Typical High $28.18 | Professional | 55 · Aftercare only | $17.38 | $22.39 | $28.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.79 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.48 | $14.79 | $18.62 |
Where Texas sits
The same service costs 3.8 times more in Alaska than in New York. 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· 41st of 51
$229
AK $741NY $195
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.