How much rates vary
Facilitymedian $102,329 · 10th to 90th $40,738 to $204,174Professionalmedian $75,858 · 10th to 90th $67,608 to $77,625
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 $75,857.76 Median $104,712.85 Typical High $144,543.98 | Facility | None | $75,857.76 | $104,712.85 | $144,543.98 |
Aetna Setting Professional Modifier None Typical Low $74,131.02 Median $75,857.76 Typical High $87,096.36 | Professional | None | $74,131.02 | $75,857.76 | $87,096.36 |
BCBS Texas Setting Facility Modifier None Typical Low $40,738.03 Median $102,329.30 Typical High $194,984.46 | Facility | None | $40,738.03 | $102,329.30 | $194,984.46 |
BCBS Texas Setting Professional Modifier None Typical Low $67,608.30 Median $67,608.30 Typical High $67,608.30 | Professional | None | $67,608.30 | $67,608.30 | $67,608.30 |
Cigna Setting Facility Modifier None Typical Low $77,624.71 Median $117,489.76 Typical High $251,188.64 | Facility | None | $77,624.71 | $117,489.76 | $251,188.64 |
Cigna Setting Professional Modifier None Typical Low $77,624.71 Median $77,624.71 Typical High $77,624.71 | Professional | None | $77,624.71 | $77,624.71 | $77,624.71 |
Moda Health Setting Facility Modifier None Typical Low $26,302.68 Median $83,176.38 Typical High $138,038.43 | Facility | None | $26,302.68 | $83,176.38 | $138,038.43 |
Moda Health Setting Professional Modifier None Typical Low $67,608.30 Median $69,183.10 Typical High $69,183.10 | Professional | None | $67,608.30 | $69,183.10 | $69,183.10 |
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 $33,884.42 Median $87,096.36 Typical High $660,693.45 | Facility | None | $33,884.42 | $87,096.36 | $660,693.45 |
Providence Setting Professional Modifier None Typical Low $77,624.71 Median $77,624.71 Typical High $77,624.71 | Professional | None | $77,624.71 | $77,624.71 | $77,624.71 |
United Setting Professional Modifier None Typical Low $75,857.76 Median $75,857.76 Typical High $75,857.76 | Professional | None | $75,857.76 | $75,857.76 | $75,857.76 |
Wellpoint Setting Professional Modifier None Typical Low $69,183.10 Median $69,183.10 Typical High $69,183.10 | Professional | None | $69,183.10 | $69,183.10 | $69,183.10 |
12 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 $38,018.94 Median $52,480.75 Typical High $72,443.60 | Facility | 52 · Reduced service | $38,018.94 | $52,480.75 | $72,443.60 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15,135.61 Median $21,379.62 Typical High $28,840.32 | Facility | 53 · Discontinued | $15,135.61 | $21,379.62 | $28,840.32 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11,220.18 Median $15,848.93 Typical High $21,877.62 | Facility | 55 · Aftercare only | $11,220.18 | $15,848.93 | $21,877.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7,585.78 Median $10,471.29 Typical High $14,454.40 | Facility | 56 · Pre-op care only | $7,585.78 | $10,471.29 | $14,454.40 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36,307.81 Median $38,018.94 Typical High $43,651.58 | Professional | 52 · Reduced service | $36,307.81 | $38,018.94 | $43,651.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14,791.08 Median $15,135.61 Typical High $17,378.01 | Professional | 53 · Discontinued | $14,791.08 | $15,135.61 | $17,378.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10,964.78 Median $11,220.18 Typical High $13,182.57 | Professional | 55 · Aftercare only | $10,964.78 | $11,220.18 | $13,182.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7,413.10 Median $7,585.78 Typical High $8,709.64 | Professional | 56 · Pre-op care only | $7,413.10 | $7,585.78 | $8,709.64 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33,113.11 Median $34,673.69 Typical High $34,673.69 | Professional | 52 · Reduced service | $33,113.11 | $34,673.69 | $34,673.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13,489.63 Median $13,803.84 Typical High $13,803.84 | Professional | 53 · Discontinued | $13,489.63 | $13,803.84 | $13,803.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10,000.00 Median $10,232.93 Typical High $10,232.93 | Professional | 55 · Aftercare only | $10,000.00 | $10,232.93 | $10,232.93 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6,760.83 Median $6,918.31 Typical High $6,918.31 | Professional | 56 · Pre-op care only | $6,760.83 | $6,918.31 | $6,918.31 |
Where Texas sits
The same service costs 3.4 times more in Alaska than in Nebraska. 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
$77,625
AK $123,027NE $36,308
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.