How much rates vary
Facilitymedian $398 · 10th to 90th $200 to $912Professionalmedian $372 · 10th to 90th $204 to $398
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 $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $436.52 | Professional | None | $338.84 | $398.11 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $79.43 Typical High $602.56 | Professional | None | $67.61 | $79.43 | $602.56 |
BCBS Texas Setting Facility Modifier None Typical Low $223.87 Median $549.54 Typical High $1,023.29 | Facility | None | $223.87 | $549.54 | $1,023.29 |
BCBS Texas Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Baylor Scott & White Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $1,122.02 | Facility | None | $537.03 | $537.03 | $1,122.02 |
Christus Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $549.54 Typical High $1,174.90 | Facility | None | $371.54 | $549.54 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Health Smart Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $398.11 | Professional | None | $338.84 | $338.84 | $398.11 |
Lucent Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $398.11 | Professional | None | $338.84 | $338.84 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $354.81 Median $446.68 Typical High $851.14 | Facility | None | $354.81 | $446.68 | $851.14 |
Moda Health Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $436.52 | Professional | None | $316.23 | $398.11 | $436.52 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $354.81 Typical High $354.81 | Professional | None | $30.20 | $354.81 | $354.81 |
Oscar Health Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Providence Setting Facility Modifier None Typical Low $371.54 Median $446.68 Typical High $3,162.28 | Facility | None | $371.54 | $446.68 | $3,162.28 |
Providence Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
United Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $398.11 | Professional | None | $309.03 | $389.05 | $398.11 |
Wellpoint Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
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 $165.96 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $165.96 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $67.61 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $50.12 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $33.88 | $39.81 | $39.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $199.53 | $199.53 | $199.53 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $79.43 | $79.43 | $79.43 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $58.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $39.81 |
Where Texas sits
The same service costs 3.0 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· 19th of 51
$372
AZ $490AL $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.