How much rates vary
Facilitymedian $316 · 10th to 90th $141 to $631Professionalmedian $288 · 10th to 90th $138 to $309
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 $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $309.03 | Professional | None | $263.03 | $309.03 | $309.03 |
BCBS Texas Setting Facility Modifier None Typical Low $138.04 Median $309.03 Typical High $588.84 | Facility | None | $138.04 | $309.03 | $588.84 |
BCBS Texas Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $912.01 | Facility | None | $288.40 | $426.58 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $309.03 Typical High $436.52 | Facility | None | $120.23 | $309.03 | $436.52 |
Moda Health Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $309.03 | Professional | None | $263.03 | $309.03 | $309.03 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $169.82 Median $323.59 Typical High $2,454.71 | Facility | None | $169.82 | $323.59 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
United Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $309.03 | Professional | None | $245.47 | $302.00 | $309.03 |
Wellpoint Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
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 $131.83 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $131.83 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $52.48 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $38.90 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $26.30 | $30.90 | $30.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $154.88 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $61.66 | $61.66 | $61.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $45.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $30.90 |
Where Texas sits
The same service costs 3.9 times more in Arizona than in Montana. 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· 7th of 51
$295
AZ $407MT $105
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.