How much rates vary
Facilitymedian $3,236 · 10th to 90th $389 to $10,715Professionalmedian $457 · 10th to 90th $65 to $5,248
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 $812.83 Median $3,235.94 Typical High $12,589.25 | Facility | None | $812.83 | $3,235.94 | $12,589.25 |
Aetna Setting Professional Modifier None (both parts) Typical Low $436.52 Median $562.34 Typical High $3,715.35 | Professional | None (both parts) | $436.52 | $562.34 | $3,715.35 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $141.25 Median $177.83 Typical High $263.03 | Professional | 26 · Professional part | $141.25 | $177.83 | $263.03 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $295.12 Median $363.08 Typical High $524.81 | Professional | TC · Technical part | $295.12 | $363.08 | $524.81 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 26 · Professional part | $257.04 | $257.04 | $257.04 |
BCBS Texas Setting Facility Modifier None Typical Low $1,659.59 Median $5,128.61 Typical High $11,481.54 | Facility | None | $1,659.59 | $5,128.61 | $11,481.54 |
BCBS Texas Setting Professional Modifier None (both parts) Typical Low $204.17 Median $537.03 Typical High $1,000.00 | Professional | None (both parts) | $204.17 | $537.03 | $1,000.00 |
Christus Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Christus Setting Professional Modifier 26 · Professional part Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 26 · Professional part | $213.80 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,230.27 Typical High $2,511.89 | Facility | None | $891.25 | $1,230.27 | $2,511.89 |
Cigna Setting Professional Modifier None (both parts) Typical Low $630.96 Median $776.25 Typical High $1,318.26 | Professional | None (both parts) | $630.96 | $776.25 | $1,318.26 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $229.09 Median $269.15 Typical High $416.87 | Professional | 26 · Professional part | $229.09 | $269.15 | $416.87 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $407.38 Median $512.86 Typical High $891.25 | Professional | TC · Technical part | $407.38 | $512.86 | $891.25 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $5,248.07 Median $5,248.07 Typical High $5,623.41 | Professional | None (both parts) | $5,248.07 | $5,248.07 | $5,623.41 |
Lucent Health Setting Professional Modifier 26 · Professional part Typical Low $1,698.24 Median $1,698.24 Typical High $1,862.09 | Professional | 26 · Professional part | $1,698.24 | $1,698.24 | $1,862.09 |
Lucent Health Setting Professional Modifier TC · Technical part Typical Low $2,884.03 Median $2,884.03 Typical High $4,073.80 | Professional | TC · Technical part | $2,884.03 | $2,884.03 | $4,073.80 |
Moda Health Setting Facility Modifier None Typical Low $575.44 Median $2,884.03 Typical High $13,182.57 | Facility | None | $575.44 | $2,884.03 | $13,182.57 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $436.52 Median $562.34 Typical High $1,174.90 | Professional | None (both parts) | $436.52 | $562.34 | $1,174.90 |
Moda Health Setting Professional Modifier 26 · Professional part Typical Low $141.25 Median $181.97 Typical High $309.03 | Professional | 26 · Professional part | $141.25 | $181.97 | $309.03 |
Moda Health Setting Professional Modifier TC · Technical part Typical Low $295.12 Median $371.54 Typical High $616.60 | Professional | TC · Technical part | $295.12 | $371.54 | $616.60 |
Molina Setting Professional Modifier None (both parts) Typical Low $35.48 Median $190.55 Typical High $588.84 | Professional | None (both parts) | $35.48 | $190.55 | $588.84 |
Providence Setting Facility Modifier None Typical Low $616.60 Median $1,318.26 Typical High $251,188.64 | Facility | None | $616.60 | $1,318.26 | $251,188.64 |
Providence Setting Professional Modifier None (both parts) Typical Low $630.96 Median $776.25 Typical High $1,288.25 | Professional | None (both parts) | $630.96 | $776.25 | $1,288.25 |
Providence Setting Professional Modifier 26 · Professional part Typical Low $229.09 Median $269.15 Typical High $416.87 | Professional | 26 · Professional part | $229.09 | $269.15 | $416.87 |
Providence Setting Professional Modifier TC · Technical part Typical Low $407.38 Median $512.86 Typical High $851.14 | Professional | TC · Technical part | $407.38 | $512.86 | $851.14 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,549.93 | Facility | None | $1,698.24 | $4,570.88 | $9,549.93 |
United Setting Professional Modifier None (both parts) Typical Low $575.44 Median $758.58 Typical High $1,174.90 | Professional | None (both parts) | $575.44 | $758.58 | $1,174.90 |
United Setting Professional Modifier 26 · Professional part Typical Low $181.97 Median $245.47 Typical High $380.19 | Professional | 26 · Professional part | $181.97 | $245.47 | $380.19 |
United Setting Professional Modifier TC · Technical part Typical Low $371.54 Median $524.81 Typical High $794.33 | Professional | TC · Technical part | $371.54 | $524.81 | $794.33 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None (both parts) | $645.65 | $645.65 | $645.65 |
Wellpoint Setting Professional Modifier 26 · Professional part Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 26 · Professional part | $218.78 | $218.78 | $218.78 |
Wellpoint Setting Professional Modifier TC · Technical part Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | TC · Technical part | $426.58 | $426.58 | $426.58 |
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 $218.78 Median $269.15 Typical High $346.74 | Professional | 52 · Reduced service | $218.78 | $269.15 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $107.15 Typical High $138.04 | Professional | 53 · Discontinued | $87.10 | $107.15 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $398.11 Typical High $512.86 | Professional | 54 · Surgery only | $331.13 | $398.11 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $81.28 Typical High $102.33 | Professional | 55 · Aftercare only | $66.07 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $53.70 Typical High $69.18 | Professional | 56 · Pre-op care only | $43.65 | $53.70 | $69.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $269.15 Typical High $346.74 | Professional | 52 · Reduced service | $218.78 | $269.15 | $346.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $107.15 Typical High $138.04 | Professional | 53 · Discontinued | $87.10 | $107.15 | $138.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $398.11 Typical High $512.86 | Professional | 54 · Surgery only | $331.13 | $398.11 | $512.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $81.28 Typical High $102.33 | Professional | 55 · Aftercare only | $66.07 | $81.28 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $53.70 Typical High $69.18 | Professional | 56 · Pre-op care only | $43.65 | $53.70 | $69.18 |
Where Texas sits
The same service costs 4.4 times more in Wisconsin than in Texas. 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· 51st of 51
$603
WI $2,630TX $603
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.