How much rates vary
Facilitymedian $407 · 10th to 90th $166 to $776Professionalmedian $214 · 10th to 90th $178 to $229
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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $229.09 Typical High $229.09 | Professional | None | $213.80 | $229.09 | $229.09 |
BCBS Texas Setting Facility Modifier None Typical Low $165.96 Median $407.38 Typical High $776.25 | Facility | None | $165.96 | $407.38 | $776.25 |
BCBS Texas Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $316.23 Typical High $676.08 | Facility | None | $213.80 | $316.23 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Moda Health Setting Facility Modifier None Typical Low $144.54 Median $218.78 Typical High $309.03 | Facility | None | $144.54 | $218.78 | $309.03 |
Moda Health Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $218.78 | Professional | None | $186.21 | $218.78 | $218.78 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $302.00 Typical High $1,819.70 | Facility | None | $162.18 | $302.00 | $1,819.70 |
Providence Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
United Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
United Setting Professional Modifier None Typical Low $177.83 Median $223.87 Typical High $229.09 | Professional | None | $177.83 | $223.87 | $229.09 |
Wellpoint Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
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 $95.50 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $95.50 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $38.90 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $28.84 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $19.50 | $22.91 | $22.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $109.65 | $109.65 | $109.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $43.65 | $43.65 | $43.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $33.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $21.88 | $21.88 | $21.88 |
Where Texas sits
The same service costs 1.9 times more in Arizona than in Alabama. 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
$257
AZ $302AL $162
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.