How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $346.74 Median $346.74 Typical High $389.05 | Facility | None | $346.74 | $346.74 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $389.05 | Professional | None | $295.12 | $346.74 | $389.05 |
BCBS Texas Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Lucent Health Setting Professional Modifier None Typical Low $3,548.13 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,548.13 | $3,801.89 | $3,801.89 |
Moda Health Setting Facility Modifier None Typical Low $346.74 Median $478.63 Typical High $724.44 | Facility | None | $346.74 | $478.63 | $724.44 |
Moda Health Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $389.05 | Professional | None | $295.12 | $346.74 | $389.05 |
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 $346.74 Median $501.19 Typical High $602.56 | Facility | None | $346.74 | $501.19 | $602.56 |
Providence Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
United Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $501.19 | Professional | None | $234.42 | $281.84 | $501.19 |
Wellpoint Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
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 $147.91 Median $173.78 Typical High $194.98 | Professional | 52 · Reduced service | $147.91 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $69.18 Typical High $77.62 | Professional | 53 · Discontinued | $60.26 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $51.29 Typical High $58.88 | Professional | 55 · Aftercare only | $44.67 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $34.67 Typical High $38.90 | Professional | 56 · Pre-op care only | $29.51 | $34.67 | $38.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $173.78 Typical High $194.98 | Professional | 52 · Reduced service | $147.91 | $173.78 | $194.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $69.18 Typical High $77.62 | Professional | 53 · Discontinued | $60.26 | $69.18 | $77.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $51.29 Typical High $58.88 | Professional | 55 · Aftercare only | $44.67 | $51.29 | $58.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $34.67 Typical High $38.90 | Professional | 56 · Pre-op care only | $29.51 | $34.67 | $38.90 |
Where Texas sits
The same service costs 17.0 times more in Iowa than in Kentucky. 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· 21st of 51
$372
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.