How much rates vary
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 $776.25 Median $794.33 Typical High $1,862.09 | Facility | None | $776.25 | $794.33 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $794.33 Typical High $794.33 | Professional | None | $776.25 | $794.33 | $794.33 |
BCBS Texas Setting Facility Modifier None Typical Low $758.58 Median $1,862.09 Typical High $3,467.37 | Facility | None | $758.58 | $1,862.09 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,949.84 Typical High $2,630.27 | Facility | None | $831.76 | $1,949.84 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Moda Health Setting Facility Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,862.09 | Facility | None | $776.25 | $1,047.13 | $1,862.09 |
Moda Health Setting Professional Modifier None Typical Low $776.25 Median $794.33 Typical High $794.33 | Professional | None | $776.25 | $794.33 | $794.33 |
Providence Setting Facility Modifier None Typical Low $794.33 Median $1,148.15 Typical High $7,079.46 | Facility | None | $794.33 | $1,148.15 | $7,079.46 |
Providence Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
United Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Wellpoint Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
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 $389.05 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $389.05 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $154.88 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $117.49 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $77.62 | $79.43 | $79.43 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $389.05 | $398.11 | $398.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $154.88 | $158.49 | $158.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $117.49 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $77.62 | $79.43 | $79.43 |
Where Texas sits
The same service costs 295.1 times more in Alabama than in Montana. 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· 2nd of 51
$1,514
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.