How much rates vary
Facilitymedian $2,455 · 10th to 90th $8 to $6,918Professionalmedian $10 · 10th to 90th $6 to $380
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 $724.44 Median $3,715.35 Typical High $9,120.11 | Facility | None | $724.44 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $5.89 Median $7.24 Typical High $9.33 | Professional | None | $5.89 | $7.24 | $9.33 |
BCBS Texas Setting Professional Modifier None Typical Low $6.17 Median $9.55 Typical High $16.98 | Professional | None | $6.17 | $9.55 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $1.62 Median $64.57 Typical High $346.74 | Facility | None | $1.62 | $64.57 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $6.17 Median $9.12 Typical High $14.79 | Professional | None | $6.17 | $9.12 | $14.79 |
Lucent Health Setting Professional Modifier None Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | None | $363.08 | $380.19 | $380.19 |
Moda Health Setting Facility Modifier None Typical Low $7.94 Median $1,995.26 Typical High $6,918.31 | Facility | None | $7.94 | $1,995.26 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $5.89 Median $7.41 Typical High $9.33 | Professional | None | $5.89 | $7.41 | $9.33 |
Molina Setting Professional Modifier None Typical Low $5.62 Median $6.17 Typical High $6.46 | Professional | None | $5.62 | $6.17 | $6.46 |
Providence Setting Facility Modifier None Typical Low $3.09 Median $9.33 Typical High $138.04 | Facility | None | $3.09 | $9.33 | $138.04 |
Providence Setting Professional Modifier None Typical Low $6.17 Median $9.12 Typical High $14.45 | Professional | None | $6.17 | $9.12 | $14.45 |
United Setting Facility Modifier None Typical Low $194.98 Median $204.17 Typical High $269.15 | Facility | None | $194.98 | $204.17 | $269.15 |
United Setting Professional Modifier None Typical Low $6.17 Median $8.71 Typical High $13.18 | Professional | None | $6.17 | $8.71 | $13.18 |
Wellpoint Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
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 $2.95 Median $3.63 Typical High $4.68 | Professional | 52 · Reduced service | $2.95 | $3.63 | $4.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.17 Median $1.45 Typical High $1.86 | Professional | 53 · Discontinued | $1.17 | $1.45 | $1.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.47 Median $5.50 Typical High $6.92 | Professional | 54 · Surgery only | $4.47 | $5.50 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.89 Median $1.07 Typical High $1.38 | Professional | 55 · Aftercare only | $0.89 | $1.07 | $1.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.72 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.59 | $0.72 | $0.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.95 Median $3.63 Typical High $4.68 | Professional | 52 · Reduced service | $2.95 | $3.63 | $4.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.17 Median $1.45 Typical High $1.86 | Professional | 53 · Discontinued | $1.17 | $1.45 | $1.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $4.47 Median $5.37 Typical High $6.92 | Professional | 54 · Surgery only | $4.47 | $5.37 | $6.92 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.89 Median $1.07 Typical High $1.38 | Professional | 55 · Aftercare only | $0.89 | $1.07 | $1.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.59 Median $0.72 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.59 | $0.72 | $0.93 |
Where Texas sits
The same service costs 2.3 times more in Hawaii than in North Carolina. 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
$10.47
HI $18.20NC $7.76
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.