How much rates vary
Facilitymedian $251 · 10th to 90th $100 to $692Professionalmedian $214 · 10th to 90th $195 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 $275.42 | Facility | None | $229.09 | $229.09 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $251.19 | Professional | None | $194.98 | $229.09 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $52.48 Median $61.66 Typical High $363.08 | Professional | None | $52.48 | $61.66 | $363.08 |
BCBS Texas Setting Facility Modifier None Typical Low $173.78 Median $426.58 Typical High $794.33 | Facility | None | $173.78 | $426.58 | $794.33 |
BCBS Texas Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Christus Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $323.59 Typical High $691.83 | Facility | None | $213.80 | $323.59 | $691.83 |
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 $109.65 Median $245.47 Typical High $467.74 | Facility | None | $109.65 | $245.47 | $467.74 |
Moda Health Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $257.04 | Professional | None | $194.98 | $229.09 | $257.04 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $204.17 Typical High $204.17 | Professional | None | $30.20 | $204.17 | $204.17 |
Oscar Health Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $245.47 Typical High $1,819.70 | Facility | None | $144.54 | $245.47 | $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 Professional Modifier None Typical Low $181.97 Median $223.87 Typical High $229.09 | Professional | None | $181.97 | $223.87 | $229.09 |
Wellpoint Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $97.72 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $97.72 | $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 $29.51 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $29.51 | $34.67 | $34.67 |
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 $114.82 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $114.82 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $45.71 | $45.71 | $45.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $34.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $22.91 |
Where Texas sits
The same service costs 549.5 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· 8th of 51
$224
AZ $275RI $0.50
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.