How much rates vary
Facilitymedian $16,982 · 10th to 90th $4,786 to $38,905Professionalmedian $912 · 10th to 90th $4 to $3,020
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 $1,318.26 Median $4,570.88 Typical High $15,135.61 | Facility | None | $1,318.26 | $4,570.88 | $15,135.61 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $8,912.51 | Professional | None | $912.01 | $912.01 | $8,912.51 |
BCBS Texas Setting Facility Modifier None Typical Low $10,000.00 Median $19,054.61 Typical High $53,703.18 | Facility | None | $10,000.00 | $19,054.61 | $53,703.18 |
Christus Setting Facility Modifier None Typical Low $17,782.79 Median $17,782.79 Typical High $17,782.79 | Facility | None | $17,782.79 | $17,782.79 | $17,782.79 |
Cigna Setting Facility Modifier None Typical Low $12,022.64 Median $16,595.87 Typical High $23,442.29 | Facility | None | $12,022.64 | $16,595.87 | $23,442.29 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $4,570.88 Typical High $17,378.01 | Facility | None | $1,000.00 | $4,570.88 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,548.82 | Professional | None | $912.01 | $912.01 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $512.86 Typical High $537.03 | Professional | None | $54.95 | $512.86 | $537.03 |
Providence Setting Facility Modifier None Typical Low $12,589.25 Median $16,982.44 Typical High $26,915.35 | Facility | None | $12,589.25 | $16,982.44 | $26,915.35 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $10,232.93 Typical High $27,542.29 | Facility | None | $3,981.07 | $10,232.93 | $27,542.29 |
Wellpoint Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
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 $457.09 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $91.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $457.09 | $457.09 | $457.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $181.97 | $181.97 | $181.97 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $691.83 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $138.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $91.20 |
Where Texas sits
The same service costs 5754.4 times more in Oklahoma 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· 8th of 51
$15,488
OK $22,909ME $3.98
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.