How much rates vary
Facilitymedian $30,200 · 10th to 90th $20,893 to $50,119Professionalmedian $27,542 · 10th to 90th $21,380 to $331,131
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 $21,379.62 Median $21,379.62 Typical High $23,442.29 | Facility | None | $21,379.62 | $21,379.62 | $23,442.29 |
Aetna Setting Professional Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $42,657.95 | Professional | None | $21,379.62 | $21,379.62 | $42,657.95 |
BCBS Texas Setting Professional Modifier None Typical Low $29,512.09 Median $29,512.09 Typical High $29,512.09 | Professional | None | $29,512.09 | $29,512.09 | $29,512.09 |
Christus Setting Facility Modifier None Typical Low $50,118.72 Median $50,118.72 Typical High $50,118.72 | Facility | None | $50,118.72 | $50,118.72 | $50,118.72 |
Cigna Setting Facility Modifier None Typical Low $30,199.52 Median $30,199.52 Typical High $30,199.52 | Facility | None | $30,199.52 | $30,199.52 | $30,199.52 |
Cigna Setting Professional Modifier None Typical Low $22,387.21 Median $22,387.21 Typical High $30,199.52 | Professional | None | $22,387.21 | $22,387.21 | $30,199.52 |
Lucent Health Setting Professional Modifier None Typical Low $245,470.89 Median $331,131.12 Typical High $331,131.12 | Professional | None | $245,470.89 | $331,131.12 | $331,131.12 |
Moda Health Setting Facility Modifier None Typical Low $12,589.25 Median $27,542.29 Typical High $50,118.72 | Facility | None | $12,589.25 | $27,542.29 | $50,118.72 |
Moda Health Setting Professional Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $42,657.95 | Professional | None | $21,379.62 | $21,379.62 | $42,657.95 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $37,153.52 Typical High $37,153.52 | Professional | None | $81.28 | $37,153.52 | $37,153.52 |
Providence Setting Facility Modifier None Typical Low $20,892.96 Median $30,199.52 Typical High $50,118.72 | Facility | None | $20,892.96 | $30,199.52 | $50,118.72 |
Providence Setting Professional Modifier None Typical Low $22,387.21 Median $22,387.21 Typical High $30,199.52 | Professional | None | $22,387.21 | $22,387.21 | $30,199.52 |
United Setting Facility Modifier None Typical Low $45,708.82 Median $45,708.82 Typical High $53,703.18 | Facility | None | $45,708.82 | $45,708.82 | $53,703.18 |
United Setting Professional Modifier None Typical Low $16,218.10 Median $24,547.09 Typical High $29,512.09 | Professional | None | $16,218.10 | $24,547.09 | $29,512.09 |
Wellpoint Setting Professional Modifier None Typical Low $23,988.33 Median $23,988.33 Typical High $23,988.33 | Professional | None | $23,988.33 | $23,988.33 | $23,988.33 |
8 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 $10,715.19 Median $10,715.19 Typical High $21,379.62 | Professional | 52 · Reduced service | $10,715.19 | $10,715.19 | $21,379.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4,265.80 Median $4,265.80 Typical High $8,511.38 | Professional | 53 · Discontinued | $4,265.80 | $4,265.80 | $8,511.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3,235.94 Median $3,235.94 Typical High $6,456.54 | Professional | 55 · Aftercare only | $3,235.94 | $3,235.94 | $6,456.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2,137.96 Median $2,137.96 Typical High $4,265.80 | Professional | 56 · Pre-op care only | $2,137.96 | $2,137.96 | $4,265.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10,715.19 Median $10,715.19 Typical High $21,379.62 | Professional | 52 · Reduced service | $10,715.19 | $10,715.19 | $21,379.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4,265.80 Median $4,265.80 Typical High $8,511.38 | Professional | 53 · Discontinued | $4,265.80 | $4,265.80 | $8,511.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3,235.94 Median $3,235.94 Typical High $6,456.54 | Professional | 55 · Aftercare only | $3,235.94 | $3,235.94 | $6,456.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2,137.96 Median $2,137.96 Typical High $4,265.80 | Professional | 56 · Pre-op care only | $2,137.96 | $2,137.96 | $4,265.80 |
Where Texas sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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· 27th of 51
$28,184
HI $47,863NJ $22,387
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.