How much rates vary
Facilitymedian $1,698 · 10th to 90th $182 to $13,490Professionalmedian $380 · 10th to 90th $58 to $2,692
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 $870.96 Median $3,388.44 Typical High $12,589.25 | Facility | None | $870.96 | $3,388.44 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $4,897.79 | Professional | None | $245.47 | $323.59 | $4,897.79 |
BCBS Texas Setting Facility Modifier None Typical Low $1,023.29 Median $2,398.83 Typical High $3,311.31 | Facility | None | $1,023.29 | $2,398.83 | $3,311.31 |
BCBS Texas Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $630.96 | Professional | None | $331.13 | $446.68 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $12,022.64 Median $16,595.87 Typical High $21,877.62 | Facility | None | $12,022.64 | $16,595.87 | $21,877.62 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $741.31 | Professional | None | $389.05 | $457.09 | $741.31 |
Lucent Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,398.83 | $2,691.53 | $2,691.53 |
Moda Health Setting Facility Modifier None Typical Low $389.05 Median $2,511.89 Typical High $13,182.57 | Facility | None | $389.05 | $2,511.89 | $13,182.57 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $758.58 | Professional | None | $245.47 | $323.59 | $758.58 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $275.42 Typical High $363.08 | Professional | None | $50.12 | $275.42 | $363.08 |
Providence Setting Facility Modifier None Typical Low $323.59 Median $17,378.01 Typical High $46,773.51 | Facility | None | $323.59 | $17,378.01 | $46,773.51 |
Providence Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $741.31 | Professional | None | $380.19 | $457.09 | $741.31 |
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 $331.13 Median $457.09 Typical High $707.95 | Professional | None | $331.13 | $457.09 | $707.95 |
Wellpoint Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $123.03 Median $154.88 Typical High $204.17 | Professional | 52 · Reduced service | $123.03 | $154.88 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $61.66 Typical High $81.28 | Professional | 53 · Discontinued | $50.12 | $61.66 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $229.09 Typical High $302.00 | Professional | 54 · Surgery only | $186.21 | $229.09 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $45.71 Typical High $60.26 | Professional | 55 · Aftercare only | $37.15 | $45.71 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $30.90 Typical High $40.74 | Professional | 56 · Pre-op care only | $24.55 | $30.90 | $40.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $154.88 Typical High $199.53 | Professional | 52 · Reduced service | $123.03 | $154.88 | $199.53 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $61.66 Typical High $79.43 | Professional | 53 · Discontinued | $50.12 | $61.66 | $79.43 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $229.09 Typical High $295.12 | Professional | 54 · Surgery only | $186.21 | $229.09 | $295.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $45.71 Typical High $60.26 | Professional | 55 · Aftercare only | $37.15 | $45.71 | $60.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $30.90 Typical High $39.81 | Professional | 56 · Pre-op care only | $24.55 | $30.90 | $39.81 |
Where Texas sits
The same service costs 27.0 times more in Alabama than in Maryland. 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.
Physician feeFacility fee
AL $15,422MD $571
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.