How much rates vary
Facilitymedian $437 · 10th to 90th $182 to $832Professionalmedian $219 · 10th to 90th $191 to $234
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 $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $234.42 | Professional | None | $169.82 | $234.42 | $234.42 |
BCBS Texas Setting Facility Modifier None Typical Low $181.97 Median $446.68 Typical High $831.76 | Facility | None | $181.97 | $446.68 | $831.76 |
BCBS Texas Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $331.13 Typical High $707.95 | Facility | None | $218.78 | $331.13 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Moda Health Setting Facility Modifier None Typical Low $144.54 Median $234.42 Typical High $338.84 | Facility | None | $144.54 | $234.42 | $338.84 |
Moda Health Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $234.42 | Professional | None | $169.82 | $234.42 | $234.42 |
Molina Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $169.82 | Professional | None | $154.88 | $154.88 | $169.82 |
Providence Setting Facility Modifier None Typical Low $165.96 Median $245.47 Typical High $1,862.09 | Facility | None | $165.96 | $245.47 | $1,862.09 |
Providence Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
United Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
United Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $234.42 | Professional | None | $154.88 | $194.98 | $234.42 |
Wellpoint Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
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 $85.11 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $85.11 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $33.88 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $25.70 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $16.98 | $23.44 | $23.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $117.49 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $46.77 | $46.77 | $46.77 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $35.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $23.44 |
Where Texas sits
The same service costs 1.8 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· 8th of 51
$234
AZ $295AL $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.