How much rates vary
Facilitymedian $282 · 10th to 90th $107 to $724Professionalmedian $257 · 10th to 90th $162 to $282
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 $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $309.03 | Professional | None | $239.88 | $281.84 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $223.87 | Professional | None | $190.55 | $190.55 | $223.87 |
BCBS Texas Setting Facility Modifier None Typical Low $181.97 Median $457.09 Typical High $851.14 | Facility | None | $181.97 | $457.09 | $851.14 |
BCBS Texas Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Christus Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $398.11 Typical High $831.76 | Facility | None | $263.03 | $398.11 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Moda Health Setting Facility Modifier None Typical Low $213.80 Median $281.84 Typical High $588.84 | Facility | None | $213.80 | $281.84 | $588.84 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $288.40 | Professional | None | $229.09 | $281.84 | $288.40 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Oscar Health Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Providence Setting Facility Modifier None Typical Low $263.03 Median $316.23 Typical High $2,238.72 | Facility | None | $263.03 | $316.23 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
United Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $281.84 | Professional | None | $204.17 | $257.04 | $281.84 |
Wellpoint Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $120.23 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $120.23 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $47.86 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $36.31 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $23.99 | $28.18 | $28.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $141.25 | $141.25 | $141.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $56.23 | $56.23 | $56.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $42.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $28.18 |
Where Texas sits
The same service costs 2.1 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· 15th of 51
$263
AZ $347AL $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.