How much rates vary
Facilitymedian $1,230 · 10th to 90th $200 to $8,710Professionalmedian $617 · 10th to 90th $355 to $12,023
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 $794.33 Median $3,890.45 Typical High $12,589.25 | Facility | None | $794.33 | $3,890.45 | $12,589.25 |
Aetna Setting Professional Modifier None (both parts) Typical Low $323.59 Median $416.87 Typical High $645.65 | Professional | None (both parts) | $323.59 | $416.87 | $645.65 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $245.47 Median $309.03 Typical High $489.78 | Professional | 26 · Professional part | $245.47 | $309.03 | $489.78 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $85.11 Median $104.71 Typical High $134.90 | Professional | TC · Technical part | $85.11 | $104.71 | $134.90 |
BCBS Texas Setting Facility Modifier None Typical Low $549.54 Median $1,230.27 Typical High $2,187.76 | Facility | None | $549.54 | $1,230.27 | $2,187.76 |
BCBS Texas Setting Professional Modifier None (both parts) Typical Low $354.81 Median $398.11 Typical High $645.65 | Professional | None (both parts) | $354.81 | $398.11 | $645.65 |
Christus Setting Professional Modifier 26 · Professional part Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 26 · Professional part | $389.05 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $17,782.79 Median $19,498.45 Typical High $22,387.21 | Facility | None | $17,782.79 | $19,498.45 | $22,387.21 |
Cigna Setting Professional Modifier None (both parts) Typical Low $524.81 Median $616.60 Typical High $954.99 | Professional | None (both parts) | $524.81 | $616.60 | $954.99 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $398.11 Median $467.74 Typical High $707.95 | Professional | 26 · Professional part | $398.11 | $467.74 | $707.95 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $131.83 Median $154.88 Typical High $245.47 | Professional | TC · Technical part | $131.83 | $154.88 | $245.47 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $12,022.64 Median $12,022.64 Typical High $12,022.64 | Professional | None (both parts) | $12,022.64 | $12,022.64 | $12,022.64 |
Lucent Health Setting Professional Modifier 26 · Professional part Typical Low $3,235.94 Median $3,235.94 Typical High $3,467.37 | Professional | 26 · Professional part | $3,235.94 | $3,235.94 | $3,467.37 |
Lucent Health Setting Professional Modifier TC · Technical part Typical Low $11,481.54 Median $11,481.54 Typical High $11,481.54 | Professional | TC · Technical part | $11,481.54 | $11,481.54 | $11,481.54 |
Moda Health Setting Facility Modifier None Typical Low $588.84 Median $2,511.89 Typical High $8,317.64 | Facility | None | $588.84 | $2,511.89 | $8,317.64 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $323.59 Median $416.87 Typical High $549.54 | Professional | None (both parts) | $323.59 | $416.87 | $549.54 |
Moda Health Setting Professional Modifier 26 · Professional part Typical Low $245.47 Median $309.03 Typical High $602.56 | Professional | 26 · Professional part | $245.47 | $309.03 | $602.56 |
Moda Health Setting Professional Modifier TC · Technical part Typical Low $85.11 Median $104.71 Typical High $134.90 | Professional | TC · Technical part | $85.11 | $104.71 | $134.90 |
Molina Setting Professional Modifier None (both parts) Typical Low $218.78 Median $309.03 Typical High $537.03 | Professional | None (both parts) | $218.78 | $309.03 | $537.03 |
Providence Setting Facility Modifier None Typical Low $416.87 Median $1,122.02 Typical High $21,877.62 | Facility | None | $416.87 | $1,122.02 | $21,877.62 |
Providence Setting Professional Modifier None (both parts) Typical Low $524.81 Median $616.60 Typical High $954.99 | Professional | None (both parts) | $524.81 | $616.60 | $954.99 |
Providence Setting Professional Modifier 26 · Professional part Typical Low $398.11 Median $467.74 Typical High $707.95 | Professional | 26 · Professional part | $398.11 | $467.74 | $707.95 |
Providence Setting Professional Modifier TC · Technical part Typical Low $125.89 Median $154.88 Typical High $234.42 | Professional | TC · Technical part | $125.89 | $154.88 | $234.42 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $17,782.79 | Facility | None | $141.25 | $741.31 | $17,782.79 |
United Setting Professional Modifier None (both parts) Typical Low $562.34 Median $758.58 Typical High $1,174.90 | Professional | None (both parts) | $562.34 | $758.58 | $1,174.90 |
United Setting Professional Modifier 26 · Professional part Typical Low $309.03 Median $436.52 Typical High $645.65 | Professional | 26 · Professional part | $309.03 | $436.52 | $645.65 |
United Setting Professional Modifier TC · Technical part Typical Low $234.42 Median $331.13 Typical High $501.19 | Professional | TC · Technical part | $234.42 | $331.13 | $501.19 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None (both parts) | $691.83 | $691.83 | $691.83 |
Wellpoint Setting Professional Modifier 26 · Professional part Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 26 · Professional part | $398.11 | $398.11 | $398.11 |
Wellpoint Setting Professional Modifier TC · Technical part Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | TC · Technical part | $245.47 | $245.47 | $245.47 |
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 $162.18 Median $204.17 Typical High $251.19 | Professional | 52 · Reduced service | $162.18 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $83.18 Typical High $100.00 | Professional | 53 · Discontinued | $66.07 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $309.03 Typical High $398.11 | Professional | 54 · Surgery only | $245.47 | $309.03 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $61.66 Typical High $75.86 | Professional | 55 · Aftercare only | $48.98 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $41.69 Typical High $50.12 | Professional | 56 · Pre-op care only | $32.36 | $41.69 | $50.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $204.17 Typical High $251.19 | Professional | 52 · Reduced service | $162.18 | $204.17 | $251.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $83.18 Typical High $100.00 | Professional | 53 · Discontinued | $66.07 | $83.18 | $100.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $309.03 Typical High $389.05 | Professional | 54 · Surgery only | $245.47 | $309.03 | $389.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $61.66 Typical High $75.86 | Professional | 55 · Aftercare only | $48.98 | $61.66 | $75.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $41.69 Typical High $50.12 | Professional | 56 · Pre-op care only | $32.36 | $41.69 | $50.12 |
Where Texas sits
The same service costs 5.6 times more in Nebraska 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· 32nd of 51
$741
NE $2,818MD $501
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.