How much rates vary
Facilitymedian $339 · 10th to 90th $141 to $631Professionalmedian $182 · 10th to 90th $138 to $191
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 $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $190.55 | Professional | None | $141.25 | $190.55 | $190.55 |
BCBS Texas Setting Facility Modifier None Typical Low $141.25 Median $346.74 Typical High $645.65 | Facility | None | $141.25 | $346.74 | $645.65 |
BCBS Texas Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $269.15 Typical High $588.84 | Facility | None | $154.88 | $269.15 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Moda Health Setting Facility Modifier None Typical Low $138.04 Median $190.55 Typical High $269.15 | Facility | None | $138.04 | $190.55 | $269.15 |
Moda Health Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $190.55 | Professional | None | $141.25 | $190.55 | $190.55 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Providence Setting Facility Modifier None Typical Low $141.25 Median $208.93 Typical High $588.84 | Facility | None | $141.25 | $208.93 | $588.84 |
Providence Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
United Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $199.53 | Professional | None | $131.83 | $165.96 | $199.53 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
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 $70.79 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $70.79 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $28.18 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $20.89 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $14.13 | $19.05 | $19.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $95.50 | $95.50 | $95.50 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $38.02 | $38.02 | $38.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $28.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $19.05 |
Where Texas sits
The same service costs 1.8 times more in Arizona than in Rhode Island. 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· 2nd of 51
$209
AZ $245RI $138
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.