How much rates vary
Facilitymedian $1,148 · 10th to 90th $155 to $3,890Professionalmedian $288 · 10th to 90th $50 to $2,512
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 $575.44 Median $2,238.72 Typical High $6,918.31 | Facility | None | $575.44 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $229.09 Typical High $398.11 | Professional | None | $104.71 | $229.09 | $398.11 |
BCBS Texas Setting Professional Modifier None Typical Low $151.36 Median $263.03 Typical High $1,380.38 | Professional | None | $151.36 | $263.03 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $912.01 Typical High $1,659.59 | Facility | None | $524.81 | $912.01 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Lucent Health Setting Professional Modifier None Typical Low $2,511.89 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,511.89 | $2,691.53 | $2,691.53 |
Moda Health Setting Facility Modifier None Typical Low $169.82 Median $1,258.93 Typical High $5,248.07 | Facility | None | $169.82 | $1,258.93 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $112.20 Median $229.09 Typical High $389.05 | Professional | None | $112.20 | $229.09 | $389.05 |
Molina Setting Professional Modifier None Typical Low $43.65 Median $239.88 Typical High $323.59 | Professional | None | $43.65 | $239.88 | $323.59 |
Providence Setting Facility Modifier None Typical Low $194.98 Median $1,479.11 Typical High $3,981.07 | Facility | None | $194.98 | $1,479.11 | $3,981.07 |
Providence Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $173.78 Median $346.74 Typical High $676.08 | Professional | None | $173.78 | $346.74 | $676.08 |
Wellpoint Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
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 $52.48 Median $104.71 Typical High $173.78 | Professional | 52 · Reduced service | $52.48 | $104.71 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $41.69 Typical High $70.79 | Professional | 53 · Discontinued | $20.89 | $41.69 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $154.88 Typical High $263.03 | Professional | 54 · Surgery only | $77.62 | $154.88 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $31.62 Typical High $52.48 | Professional | 55 · Aftercare only | $15.49 | $31.62 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $20.89 Typical High $34.67 | Professional | 56 · Pre-op care only | $10.47 | $20.89 | $34.67 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $104.71 Typical High $173.78 | Professional | 52 · Reduced service | $52.48 | $104.71 | $173.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $41.69 Typical High $70.79 | Professional | 53 · Discontinued | $20.89 | $41.69 | $70.79 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $154.88 Typical High $263.03 | Professional | 54 · Surgery only | $77.62 | $154.88 | $263.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $31.62 Typical High $52.48 | Professional | 55 · Aftercare only | $15.49 | $31.62 | $52.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $20.89 Typical High $34.67 | Professional | 56 · Pre-op care only | $10.47 | $20.89 | $34.67 |
Where Texas sits
The same service costs 2.8 times more in Wisconsin than in Utah. 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
$288
WI $813UT $288
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.