How much rates vary
Facilitymedian $537 · 10th to 90th $158 to $1,950Professionalmedian $204 · 10th to 90th $32 to $1,514
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 $181.97 Median $213.80 Typical High $245.47 | Facility | None | $181.97 | $213.80 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $309.03 | Professional | None | $181.97 | $213.80 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | None | $190.55 | $190.55 | $199.53 |
BCBS Texas Setting Facility Modifier None Typical Low $218.78 Median $512.86 Typical High $891.25 | Facility | None | $218.78 | $512.86 | $891.25 |
BCBS Texas Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $363.08 | Professional | None | $194.98 | $269.15 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $173.78 Typical High $229.09 | Facility | None | $158.49 | $173.78 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $295.12 | Professional | None | $177.83 | $234.42 | $295.12 |
Lucent Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,513.56 | $1,905.46 | $1,905.46 |
Moda Health Setting Facility Modifier None Typical Low $199.53 Median $218.78 Typical High $371.54 | Facility | None | $199.53 | $218.78 | $371.54 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $309.03 | Professional | None | $181.97 | $213.80 | $309.03 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $158.49 Typical High $218.78 | Professional | None | $28.84 | $158.49 | $218.78 |
Providence Setting Facility Modifier None Typical Low $181.97 Median $213.80 Typical High $331.13 | Facility | None | $181.97 | $213.80 | $331.13 |
Providence Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $288.40 | Professional | None | $177.83 | $234.42 | $288.40 |
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 $162.18 Median $218.78 Typical High $316.23 | Professional | None | $162.18 | $218.78 | $316.23 |
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 $91.20 Median $107.15 Typical High $123.03 | Professional | 52 · Reduced service | $91.20 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $43.65 Typical High $48.98 | Professional | 53 · Discontinued | $36.31 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $32.36 Typical High $37.15 | Professional | 55 · Aftercare only | $27.54 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $21.38 Typical High $24.55 | Professional | 56 · Pre-op care only | $18.20 | $21.38 | $24.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $107.15 Typical High $123.03 | Professional | 52 · Reduced service | $91.20 | $107.15 | $123.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $43.65 Typical High $48.98 | Professional | 53 · Discontinued | $36.31 | $43.65 | $48.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $32.36 Typical High $37.15 | Professional | 55 · Aftercare only | $27.54 | $32.36 | $37.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $21.38 Typical High $24.55 | Professional | 56 · Pre-op care only | $18.20 | $21.38 | $24.55 |
Where Texas sits
The same service costs 3.0 times more in Wisconsin than in Florida. 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· 45th of 51
$209
WI $537FL $182
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.