How much rates vary
Facilitymedian $6,026 · 10th to 90th $2,089 to $13,183Professionalmedian $1,660 · 10th to 90th $219 to $2,089
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 $1,513.56 Median $4,786.30 Typical High $13,182.57 | Facility | None | $1,513.56 | $4,786.30 | $13,182.57 |
Aetna Setting Professional Modifier None (both parts) Typical Low $173.78 Median $173.78 Typical High $13,489.63 | Professional | None (both parts) | $173.78 | $173.78 | $13,489.63 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $173.78 Median $213.80 Typical High $275.42 | Professional | 26 · Professional part | $173.78 | $213.80 | $275.42 |
BCBS Texas Setting Facility Modifier None Typical Low $3,311.31 Median $7,244.36 Typical High $13,182.57 | Facility | None | $3,311.31 | $7,244.36 | $13,182.57 |
BCBS Texas Setting Professional Modifier None (both parts) Typical Low $204.17 Median $204.17 Typical High $302.00 | Professional | None (both parts) | $204.17 | $204.17 | $302.00 |
Christus Setting Professional Modifier 26 · Professional part Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 26 · Professional part | $251.19 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $6,918.31 Median $10,471.29 Typical High $16,595.87 | Facility | None | $6,918.31 | $10,471.29 | $16,595.87 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $263.03 Median $309.03 Typical High $467.74 | Professional | 26 · Professional part | $263.03 | $309.03 | $467.74 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $1,659.59 Median $2,089.30 Typical High $2,089.30 | Professional | None (both parts) | $1,659.59 | $2,089.30 | $2,089.30 |
Lucent Health Setting Professional Modifier 26 · Professional part Typical Low $1,659.59 Median $2,089.30 Typical High $2,089.30 | Professional | 26 · Professional part | $1,659.59 | $2,089.30 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $309.03 Median $3,715.35 Typical High $12,302.69 | Facility | None | $309.03 | $3,715.35 | $12,302.69 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $173.78 Median $173.78 Typical High $10,964.78 | Professional | None (both parts) | $173.78 | $173.78 | $10,964.78 |
Moda Health Setting Professional Modifier 26 · Professional part Typical Low $173.78 Median $218.78 Typical High $363.08 | Professional | 26 · Professional part | $173.78 | $218.78 | $363.08 |
Providence Setting Facility Modifier None Typical Low $245.47 Median $2,754.23 Typical High $28,183.83 | Facility | None | $245.47 | $2,754.23 | $28,183.83 |
Providence Setting Professional Modifier None (both parts) Typical Low $251.19 Median $1,819,700.86 Typical High $2,398,832.92 | Professional | None (both parts) | $251.19 | $1,819,700.86 | $2,398,832.92 |
Providence Setting Professional Modifier 26 · Professional part Typical Low $257.04 Median $309.03 Typical High $467.74 | Professional | 26 · Professional part | $257.04 | $309.03 | $467.74 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $12,302.69 | Facility | None | $2,137.96 | $5,248.07 | $12,302.69 |
United Setting Professional Modifier None (both parts) Typical Low $213.80 Median $295.12 Typical High $467.74 | Professional | None (both parts) | $213.80 | $295.12 | $467.74 |
United Setting Professional Modifier 26 · Professional part Typical Low $213.80 Median $295.12 Typical High $467.74 | Professional | 26 · Professional part | $213.80 | $295.12 | $467.74 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None (both parts) | $436.52 | $436.52 | $436.52 |
Wellpoint Setting Professional Modifier 26 · Professional part Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 26 · Professional part | $251.19 | $251.19 | $251.19 |
11 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 $87.10 Median $107.15 Typical High $131.83 | Professional | 52 · Reduced service | $87.10 | $107.15 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $42.66 Typical High $52.48 | Professional | 53 · Discontinued | $34.67 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $158.49 Typical High $199.53 | Professional | 54 · Surgery only | $128.82 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $31.62 Typical High $39.81 | Professional | 55 · Aftercare only | $25.70 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $21.38 Typical High $26.30 | Professional | 56 · Pre-op care only | $17.38 | $21.38 | $26.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $107.15 Typical High $131.83 | Professional | 52 · Reduced service | $87.10 | $107.15 | $131.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $42.66 Typical High $52.48 | Professional | 53 · Discontinued | $34.67 | $42.66 | $52.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $158.49 Typical High $194.98 | Professional | 54 · Surgery only | $128.82 | $158.49 | $194.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $31.62 Typical High $39.81 | Professional | 55 · Aftercare only | $25.70 | $31.62 | $39.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $21.38 Typical High $26.30 | Professional | 56 · Pre-op care only | $17.38 | $21.38 | $26.30 |
Wellpoint Setting Professional Modifier TC · Technical part Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | TC · Technical part | $1,380.38 | $1,380.38 | $1,380.38 |
Where Texas sits
The same service costs 19.5 times more in Colorado 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.
Texas· 12th of 51
$2,692
CO $6,761MD $347
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.