How much rates vary
Facilitymedian $15,849 · 10th to 90th $7,413 to $28,840Professionalmedian $8,913 · 10th to 90th $8,511 to $47,863
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 $8,511.38 Median $11,220.18 Typical High $18,197.01 | Facility | None | $8,511.38 | $11,220.18 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $8,511.38 Median $8,709.64 Typical High $8,709.64 | Professional | None | $8,511.38 | $8,709.64 | $8,709.64 |
BCBS Texas Setting Facility Modifier None Typical Low $7,079.46 Median $18,197.01 Typical High $30,199.52 | Facility | None | $7,079.46 | $18,197.01 | $30,199.52 |
Cigna Setting Facility Modifier None Typical Low $8,912.51 Median $13,489.63 Typical High $28,840.32 | Facility | None | $8,912.51 | $13,489.63 | $28,840.32 |
Cigna Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
Lucent Health Setting Professional Modifier None Typical Low $47,863.01 Median $47,863.01 Typical High $47,863.01 | Professional | None | $47,863.01 | $47,863.01 | $47,863.01 |
Moda Health Setting Facility Modifier None Typical Low $562.34 Median $10,471.29 Typical High $17,378.01 | Facility | None | $562.34 | $10,471.29 | $17,378.01 |
Moda Health Setting Professional Modifier None Typical Low $8,511.38 Median $8,709.64 Typical High $8,709.64 | Professional | None | $8,511.38 | $8,709.64 | $8,709.64 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $8,709.64 Typical High $10,000.00 | Professional | None | $30.20 | $8,709.64 | $10,000.00 |
Providence Setting Facility Modifier None Typical Low $457.09 Median $12,589.25 Typical High $75,857.76 | Facility | None | $457.09 | $12,589.25 | $75,857.76 |
Providence Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
United Setting Professional Modifier None Typical Low $8,709.64 Median $9,332.54 Typical High $9,772.37 | Professional | None | $8,709.64 | $9,332.54 | $9,772.37 |
Wellpoint Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $8,511.38 | Professional | None | $8,511.38 | $8,511.38 | $8,511.38 |
16 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 $4,265.80 Median $5,623.41 Typical High $9,120.11 | Facility | 52 · Reduced service | $4,265.80 | $5,623.41 | $9,120.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1,698.24 Median $2,238.72 Typical High $3,630.78 | Facility | 53 · Discontinued | $1,698.24 | $2,238.72 | $3,630.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1,258.93 Median $1,698.24 Typical High $2,754.23 | Facility | 55 · Aftercare only | $1,258.93 | $1,698.24 | $2,754.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $851.14 Median $1,122.02 Typical High $1,819.70 | Facility | 56 · Pre-op care only | $851.14 | $1,122.02 | $1,819.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4,265.80 Median $4,365.16 Typical High $4,365.16 | Professional | 52 · Reduced service | $4,265.80 | $4,365.16 | $4,365.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,698.24 Median $1,737.80 Typical High $1,737.80 | Professional | 53 · Discontinued | $1,698.24 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,258.93 Median $1,288.25 Typical High $1,318.26 | Professional | 55 · Aftercare only | $1,258.93 | $1,288.25 | $1,318.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $851.14 Median $870.96 Typical High $870.96 | Professional | 56 · Pre-op care only | $851.14 | $870.96 | $870.96 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $4,265.80 Median $5,248.07 Typical High $8,709.64 | Facility | 52 · Reduced service | $4,265.80 | $5,248.07 | $8,709.64 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $1,698.24 Median $2,089.30 Typical High $3,467.37 | Facility | 53 · Discontinued | $1,698.24 | $2,089.30 | $3,467.37 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $1,258.93 Median $1,548.82 Typical High $2,630.27 | Facility | 55 · Aftercare only | $1,258.93 | $1,548.82 | $2,630.27 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $851.14 Median $1,047.13 Typical High $1,737.80 | Facility | 56 · Pre-op care only | $851.14 | $1,047.13 | $1,737.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $4,265.80 Median $4,365.16 Typical High $4,365.16 | Professional | 52 · Reduced service | $4,265.80 | $4,365.16 | $4,365.16 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,698.24 Median $1,737.80 Typical High $1,737.80 | Professional | 53 · Discontinued | $1,698.24 | $1,737.80 | $1,737.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1,258.93 Median $1,288.25 Typical High $1,288.25 | Professional | 55 · Aftercare only | $1,258.93 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $851.14 Median $870.96 Typical High $870.96 | Professional | 56 · Pre-op care only | $851.14 | $870.96 | $870.96 |
Where Texas sits
The same service costs 26.3 times more in Alaska than in Montana. 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· 13th of 51
$8,913
AK $12,303MT $468
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.