How much rates vary
Facilitymedian $724 · 10th to 90th $457 to $4,169Professionalmedian $661 · 10th to 90th $166 to $1,905
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 $165.96 Median $186.21 Typical High $338.84 | Professional | None | $165.96 | $186.21 | $338.84 |
BCBS Setting Facility Modifier None Typical Low $478.63 Median $602.56 Typical High $1,778.28 | Facility | None | $478.63 | $602.56 | $1,778.28 |
BCBS Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Christus Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Lucent Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,348.96 | $1,905.46 | $1,905.46 |
Moda Health Setting Facility Modifier None Typical Low $199.53 Median $2,454.71 Typical High $6,918.31 | Facility | None | $199.53 | $2,454.71 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $338.84 | Professional | None | $158.49 | $186.21 | $338.84 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $169.82 Median $229.09 Typical High $295.12 | Facility | None | $169.82 | $229.09 | $295.12 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $346.74 | Professional | None | $60.26 | $79.43 | $346.74 |
United Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $524.81 | Professional | None | $323.59 | $354.81 | $524.81 |
Wellpoint Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
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 $79.43 Median $85.11 Typical High $102.33 | Professional | 52 · Reduced service | $79.43 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $33.88 Typical High $41.69 | Professional | 53 · Discontinued | $31.62 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $125.89 Typical High $154.88 | Professional | 54 · Surgery only | $120.23 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $25.70 Typical High $30.90 | Professional | 55 · Aftercare only | $23.99 | $25.70 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.98 Typical High $20.89 | Professional | 56 · Pre-op care only | $15.85 | $16.98 | $20.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $83.18 Typical High $102.33 | Professional | 52 · Reduced service | $79.43 | $83.18 | $102.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $33.88 Typical High $41.69 | Professional | 53 · Discontinued | $31.62 | $33.88 | $41.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $125.89 Typical High $154.88 | Professional | 54 · Surgery only | $120.23 | $125.89 | $154.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $25.70 Typical High $30.90 | Professional | 55 · Aftercare only | $23.99 | $25.70 | $30.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $16.98 Typical High $20.89 | Professional | 56 · Pre-op care only | $15.85 | $16.98 | $20.89 |
Where Texas sits
The same service costs 25.7 times more in Oklahoma than in Vermont. 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· 3rd of 51
$661
OK $3,631VT $141
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.