How much rates vary
Facilitymedian $1,000 · 10th to 90th $398 to $1,905Professionalmedian $513 · 10th to 90th $457 to $537
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 $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $537.03 | Professional | None | $457.09 | $537.03 | $537.03 |
BCBS Texas Setting Facility Modifier None Typical Low $398.11 Median $1,023.29 Typical High $1,905.46 | Facility | None | $398.11 | $1,023.29 | $1,905.46 |
BCBS Texas Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $758.58 Typical High $1,621.81 | Facility | None | $501.19 | $758.58 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Moda Health Setting Facility Modifier None Typical Low $154.88 Median $537.03 Typical High $776.25 | Facility | None | $154.88 | $537.03 | $776.25 |
Moda Health Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $537.03 | Professional | None | $457.09 | $537.03 | $537.03 |
Molina Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Providence Setting Facility Modifier None Typical Low $426.58 Median $575.44 Typical High $4,365.16 | Facility | None | $426.58 | $575.44 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
United Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
United Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $537.03 | Professional | None | $426.58 | $537.03 | $537.03 |
Wellpoint Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
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 $229.09 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $229.09 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $93.33 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $69.18 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $45.71 | $53.70 | $53.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $269.15 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $109.65 | $109.65 | $109.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $53.70 |
Where Texas sits
The same service costs 4.9 times more in Alabama than in Hawaii. 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· 3rd of 51
$575
AL $2,089HI $427
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.