How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,660 to $14,454Professionalmedian $331 · 10th to 90th $60 to $2,291
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 $213.80 Median $275.42 Typical High $363.08 | Professional | None | $213.80 | $275.42 | $363.08 |
BCBS Texas Setting Facility Modifier None Typical Low $5,623.41 Median $10,000.00 Typical High $22,908.68 | Facility | None | $5,623.41 | $10,000.00 | $22,908.68 |
BCBS Texas Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $1,288.25 | Professional | None | $309.03 | $309.03 | $1,288.25 |
Christus Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Facility | None | $4,466.84 | $4,466.84 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,265.80 Typical High $6,025.60 | Facility | None | $758.58 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Lucent Health Setting Professional Modifier None Typical Low $2,290.87 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,290.87 | $3,019.95 | $3,019.95 |
Moda Health Setting Facility Modifier None Typical Low $346.74 Median $1,995.26 Typical High $6,918.31 | Facility | None | $346.74 | $1,995.26 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $426.58 | Professional | None | $213.80 | $281.84 | $426.58 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $309.03 Typical High $398.11 | Professional | None | $54.95 | $309.03 | $398.11 |
Providence Setting Facility Modifier None Typical Low $478.63 Median $4,168.69 Typical High $6,025.60 | Facility | None | $478.63 | $4,168.69 | $6,025.60 |
Providence Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,165.95 Typical High $15,135.61 | Facility | None | $2,630.27 | $6,165.95 | $15,135.61 |
United Setting Professional Modifier None Typical Low $288.40 Median $407.38 Typical High $602.56 | Professional | None | $288.40 | $407.38 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
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 $107.15 Median $138.04 Typical High $173.78 | Professional | 52 · Reduced service | $107.15 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $54.95 Typical High $69.18 | Professional | 53 · Discontinued | $42.66 | $54.95 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $204.17 Typical High $263.03 | Professional | 54 · Surgery only | $158.49 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $40.74 Typical High $52.48 | Professional | 55 · Aftercare only | $32.36 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $27.54 Typical High $34.67 | Professional | 56 · Pre-op care only | $21.38 | $27.54 | $34.67 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $134.90 Typical High $173.78 | Professional | 52 · Reduced service | $107.15 | $134.90 | $173.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $53.70 Typical High $69.18 | Professional | 53 · Discontinued | $42.66 | $53.70 | $69.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $204.17 Typical High $263.03 | Professional | 54 · Surgery only | $158.49 | $204.17 | $263.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $40.74 Typical High $52.48 | Professional | 55 · Aftercare only | $32.36 | $40.74 | $52.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $26.92 Typical High $34.67 | Professional | 56 · Pre-op care only | $21.38 | $26.92 | $34.67 |
Where Texas sits
The same service costs 4.5 times more in Alaska than in New York. 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· 50th of 51
$347
AK $1,479NY $331
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.