How much rates vary
Facilitymedian $1,445 · 10th to 90th $145 to $18,621Professionalmedian $191 · 10th to 90th $58 to $3,467
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 $138.04 Median $16,595.87 Typical High $26,302.68 | Facility | None | $138.04 | $16,595.87 | $26,302.68 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $213.80 | Professional | None | $107.15 | $138.04 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $83.18 | Professional | None | $81.28 | $81.28 | $83.18 |
BCBS Texas Setting Facility Modifier None Typical Low $4,168.69 Median $12,589.25 Typical High $19,498.45 | Facility | None | $4,168.69 | $12,589.25 | $19,498.45 |
BCBS Texas Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $380.19 | Professional | None | $154.88 | $213.80 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $11,748.98 Median $16,595.87 Typical High $21,877.62 | Facility | None | $11,748.98 | $16,595.87 | $21,877.62 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $316.23 | Professional | None | $177.83 | $208.93 | $316.23 |
Lucent Health Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Moda Health Setting Facility Modifier None Typical Low $79.43 Median $169.82 Typical High $26,302.68 | Facility | None | $79.43 | $169.82 | $26,302.68 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $234.42 | Professional | None | $107.15 | $138.04 | $234.42 |
Molina Setting Professional Modifier None Typical Low $10.23 Median $56.23 Typical High $77.62 | Professional | None | $10.23 | $56.23 | $77.62 |
Providence Setting Facility Modifier None Typical Low $83.18 Median $11,220.18 Typical High $46,773.51 | Facility | None | $83.18 | $11,220.18 | $46,773.51 |
Providence Setting Professional Modifier None Typical Low $173.78 Median $208.93 Typical High $316.23 | Professional | None | $173.78 | $208.93 | $316.23 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $295.12 | Professional | None | $138.04 | $194.98 | $295.12 |
Wellpoint Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
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 $53.70 Median $69.18 Typical High $87.10 | Professional | 52 · Reduced service | $53.70 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $27.54 Typical High $34.67 | Professional | 53 · Discontinued | $21.38 | $27.54 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $20.89 Typical High $26.30 | Professional | 55 · Aftercare only | $16.22 | $20.89 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.80 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.72 | $13.80 | $17.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $69.18 Typical High $87.10 | Professional | 52 · Reduced service | $53.70 | $69.18 | $87.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $27.54 Typical High $34.67 | Professional | 53 · Discontinued | $21.38 | $27.54 | $34.67 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $20.89 Typical High $26.30 | Professional | 55 · Aftercare only | $16.22 | $20.89 | $26.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.80 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.72 | $13.80 | $17.38 |
Where Texas sits
The same service costs 40.2 times more in Alabama than in Delaware. 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.
Physician feeFacility fee
AL $12,840DE $320
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.