How much rates vary
Facilitymedian $6,026 · 10th to 90th $2,089 to $13,183Professionalmedian $1,549 · 10th to 90th $363 to $10,965
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 $1,380.38 Median $4,786.30 Typical High $13,182.57 | Facility | None | $1,380.38 | $4,786.30 | $13,182.57 |
Aetna Setting Professional Modifier None (both parts) Typical Low $831.76 Median $1,047.13 Typical High $8,128.31 | Professional | None (both parts) | $831.76 | $1,047.13 | $8,128.31 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $208.93 Median $263.03 Typical High $346.74 | Professional | 26 · Professional part | $208.93 | $263.03 | $346.74 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $630.96 Median $776.25 Typical High $977.24 | Professional | TC · Technical part | $630.96 | $776.25 | $977.24 |
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 $251.19 Median $251.19 Typical High $371.54 | Professional | None (both parts) | $251.19 | $251.19 | $371.54 |
Christus Setting Professional Modifier 26 · Professional part Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 26 · Professional part | $309.03 | $309.03 | $309.03 |
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 None (both parts) Typical Low $1,258.93 Median $1,445.44 Typical High $1,659.59 | Professional | None (both parts) | $1,258.93 | $1,445.44 | $1,659.59 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $316.23 Median $389.05 Typical High $562.34 | Professional | 26 · Professional part | $316.23 | $389.05 | $562.34 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $933.25 Median $1,096.48 Typical High $1,230.27 | Professional | TC · Technical part | $933.25 | $1,096.48 | $1,230.27 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $8,128.31 Median $10,964.78 Typical High $10,964.78 | Professional | None (both parts) | $8,128.31 | $10,964.78 | $10,964.78 |
Lucent Health Setting Professional Modifier 26 · Professional part Typical Low $2,041.74 Median $2,630.27 Typical High $2,630.27 | Professional | 26 · Professional part | $2,041.74 | $2,630.27 | $2,630.27 |
Lucent Health Setting Professional Modifier TC · Technical part Typical Low $6,165.95 Median $8,317.64 Typical High $8,317.64 | Professional | TC · Technical part | $6,165.95 | $8,317.64 | $8,317.64 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $3,715.35 Typical High $13,489.63 | Facility | None | $977.24 | $3,715.35 | $13,489.63 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $831.76 Median $1,023.29 Typical High $1,513.56 | Professional | None (both parts) | $831.76 | $1,023.29 | $1,513.56 |
Moda Health Setting Professional Modifier 26 · Professional part Typical Low $208.93 Median $269.15 Typical High $457.09 | Professional | 26 · Professional part | $208.93 | $269.15 | $457.09 |
Moda Health Setting Professional Modifier TC · Technical part Typical Low $630.96 Median $776.25 Typical High $977.24 | Professional | TC · Technical part | $630.96 | $776.25 | $977.24 |
Molina Setting Professional Modifier None (both parts) Typical Low $251.19 Median $676.08 Typical High $977.24 | Professional | None (both parts) | $251.19 | $676.08 | $977.24 |
Providence Setting Facility Modifier None Typical Low $309.03 Median $2,754.23 Typical High $28,183.83 | Facility | None | $309.03 | $2,754.23 | $28,183.83 |
Providence Setting Professional Modifier None (both parts) Typical Low $1,230.27 Median $1,445.44 Typical High $1,659.59 | Professional | None (both parts) | $1,230.27 | $1,445.44 | $1,659.59 |
Providence Setting Professional Modifier 26 · Professional part Typical Low $316.23 Median $389.05 Typical High $562.34 | Professional | 26 · Professional part | $316.23 | $389.05 | $562.34 |
Providence Setting Professional Modifier TC · Technical part Typical Low $933.25 Median $1,096.48 Typical High $1,230.27 | Professional | TC · Technical part | $933.25 | $1,096.48 | $1,230.27 |
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 $269.15 Median $380.19 Typical High $602.56 | Professional | None (both parts) | $269.15 | $380.19 | $602.56 |
United Setting Professional Modifier 26 · Professional part Typical Low $257.04 Median $363.08 Typical High $575.44 | Professional | 26 · Professional part | $257.04 | $363.08 | $575.44 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None (both parts) | $1,230.27 | $1,230.27 | $1,230.27 |
Wellpoint Setting Professional Modifier 26 · Professional part Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 26 · Professional part | $316.23 | $316.23 | $316.23 |
Wellpoint Setting Professional Modifier TC · Technical part Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | TC · Technical part | $1,230.27 | $1,230.27 | $1,230.27 |
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 $416.87 Median $512.86 Typical High $630.96 | Professional | 52 · Reduced service | $416.87 | $512.86 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $204.17 Typical High $257.04 | Professional | 53 · Discontinued | $169.82 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $776.25 Typical High $954.99 | Professional | 54 · Surgery only | $630.96 | $776.25 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $154.88 Typical High $190.55 | Professional | 55 · Aftercare only | $125.89 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $102.33 Typical High $128.82 | Professional | 56 · Pre-op care only | $83.18 | $102.33 | $128.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $512.86 Typical High $630.96 | Professional | 52 · Reduced service | $416.87 | $512.86 | $630.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $204.17 Typical High $251.19 | Professional | 53 · Discontinued | $169.82 | $204.17 | $251.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $776.25 Typical High $954.99 | Professional | 54 · Surgery only | $630.96 | $776.25 | $954.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $154.88 Typical High $190.55 | Professional | 55 · Aftercare only | $125.89 | $154.88 | $190.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $102.33 Typical High $125.89 | Professional | 56 · Pre-op care only | $83.18 | $102.33 | $125.89 |
Where Texas sits
The same service costs 14.5 times more in California than in Maine. 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· 2nd of 51
$5,370
CA $8,128ME $562
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.