How much rates vary
Facilitymedian $63 · 10th to 90th $29 to $120Professionalmedian $30 · 10th to 90th $29 to $30
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 $29.51 Median $43.65 Typical High $61.66 | Facility | None | $29.51 | $43.65 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $30.20 Typical High $32.36 | Professional | None | $29.51 | $30.20 | $32.36 |
BCBS Texas Setting Facility Modifier None Typical Low $26.92 Median $64.57 Typical High $123.03 | Facility | None | $26.92 | $64.57 | $123.03 |
BCBS Texas Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $29.51 Median $56.23 Typical High $95.50 | Facility | None | $29.51 | $56.23 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Moda Health Setting Facility Modifier None Typical Low $28.84 Median $37.15 Typical High $69.18 | Facility | None | $28.84 | $37.15 | $69.18 |
Moda Health Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $31.62 | Professional | None | $28.84 | $28.84 | $31.62 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Providence Setting Facility Modifier None Typical Low $28.84 Median $41.69 Typical High $257.04 | Facility | None | $28.84 | $41.69 | $257.04 |
Providence Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
United Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
United Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Wellpoint Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
15 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 Facility Modifier 52 · Reduced service Typical Low $14.79 Median $22.91 Typical High $30.90 | Facility | 52 · Reduced service | $14.79 | $22.91 | $30.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.89 Median $9.12 Typical High $12.59 | Facility | 53 · Discontinued | $5.89 | $9.12 | $12.59 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $22.39 Median $33.88 Typical High $46.77 | Facility | 54 · Surgery only | $22.39 | $33.88 | $46.77 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.47 Median $6.92 Typical High $9.33 | Facility | 55 · Aftercare only | $4.47 | $6.92 | $9.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.95 Median $4.57 Typical High $6.17 | Facility | 56 · Pre-op care only | $2.95 | $4.57 | $6.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.79 Median $15.14 Typical High $16.22 | Professional | 52 · Reduced service | $14.79 | $15.14 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $6.03 Typical High $6.61 | Professional | 53 · Discontinued | $5.89 | $6.03 | $6.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $22.39 Typical High $24.55 | Professional | 54 · Surgery only | $22.39 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $4.90 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.02 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.95 | $3.02 | $3.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $14.45 Median $14.45 Typical High $14.79 | Professional | 52 · Reduced service | $14.45 | $14.45 | $14.79 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $5.89 | Professional | 53 · Discontinued | $5.75 | $5.75 | $5.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $21.88 Typical High $22.39 | Professional | 54 · Surgery only | $21.38 | $21.88 | $22.39 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.37 Typical High $4.47 | Professional | 55 · Aftercare only | $4.27 | $4.37 | $4.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $2.95 |
Where Texas sits
The same service costs 1.9 times more in Alaska than in Oklahoma. 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
$41.69
AK $53.70OK $27.54
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.