How much rates vary
Facilitymedian $1,202 · 10th to 90th $355 to $4,169Professionalmedian $2,042 · 10th to 90th $129 to $17,378
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 $660.69 Median $2,398.83 Typical High $6,918.31 | Facility | None | $660.69 | $2,398.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $134.90 Typical High $1,288.25 | Professional | None | $128.82 | $134.90 | $1,288.25 |
Christus Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $446.68 Typical High $1,995.26 | Facility | None | $316.23 | $446.68 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $35.48 Typical High $120.23 | Professional | None | $28.18 | $35.48 | $120.23 |
Lucent Health Setting Professional Modifier None Typical Low $10,471.29 Median $17,378.01 Typical High $17,378.01 | Professional | None | $10,471.29 | $17,378.01 | $17,378.01 |
Moda Health Setting Facility Modifier None Typical Low $141.25 Median $1,905.46 Typical High $5,495.41 | Facility | None | $141.25 | $1,905.46 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $128.82 Median $134.90 Typical High $1,288.25 | Professional | None | $128.82 | $134.90 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,737.80 | $1,737.80 | $2,041.74 |
Providence Setting Facility Modifier None Typical Low $309.03 Median $512.86 Typical High $4,466.84 | Facility | None | $309.03 | $512.86 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $263.03 | Professional | None | $109.65 | $144.54 | $263.03 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,230.27 Typical High $3,235.94 | Facility | None | $389.05 | $1,230.27 | $3,235.94 |
United Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $251.19 | Professional | None | $114.82 | $162.18 | $251.19 |
Wellpoint Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
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 $64.57 Median $67.61 Typical High $70.79 | Professional | 52 · Reduced service | $64.57 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $26.92 Typical High $28.18 | Professional | 53 · Discontinued | $25.70 | $26.92 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $20.42 Typical High $20.89 | Professional | 55 · Aftercare only | $19.50 | $20.42 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.49 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.88 | $13.49 | $14.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $67.61 Typical High $70.79 | Professional | 52 · Reduced service | $64.57 | $67.61 | $70.79 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $26.92 Typical High $28.18 | Professional | 53 · Discontinued | $25.70 | $26.92 | $28.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $20.42 Typical High $20.89 | Professional | 55 · Aftercare only | $19.50 | $20.42 | $20.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.49 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.88 | $13.49 | $14.13 |
Where Texas sits
The same service costs 24.5 times more in Texas than in Missouri. 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· 1st of 51
$1,995
TX $1,995MO $81.28
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.