How much rates vary
Facilitymedian $1,230 · 10th to 90th $117 to $2,884Professionalmedian $162 · 10th to 90th $95 to $5,012
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 $446.68 Median $446.68 Typical High $645.65 | Facility | None | $446.68 | $446.68 | $645.65 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $549.54 Typical High $707.95 | Professional | None | $331.13 | $549.54 | $707.95 |
BCBS Texas Setting Facility Modifier None Typical Low $977.24 Median $1,698.24 Typical High $3,162.28 | Facility | None | $977.24 | $1,698.24 | $3,162.28 |
BCBS Texas Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $158.49 | Professional | None | $134.90 | $158.49 | $158.49 |
Christus Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Lucent Health Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
Moda Health Setting Facility Modifier None Typical Low $446.68 Median $645.65 Typical High $933.25 | Facility | None | $446.68 | $645.65 | $933.25 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $707.95 | Professional | None | $407.38 | $549.54 | $707.95 |
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 $446.68 Median $776.25 Typical High $1,047.13 | Facility | None | $446.68 | $776.25 | $1,047.13 |
Providence Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
United Setting Facility Modifier None Typical Low $3,162.28 Median $3,235.94 Typical High $4,265.80 | Facility | None | $3,162.28 | $3,235.94 | $4,265.80 |
United Setting Professional Modifier None Typical Low $60.26 Median $151.36 Typical High $316.23 | Professional | None | $60.26 | $151.36 | $316.23 |
Wellpoint Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
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 $165.96 Median $275.42 Typical High $354.81 | Professional | 52 · Reduced service | $165.96 | $275.42 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $109.65 Typical High $141.25 | Professional | 53 · Discontinued | $66.07 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $81.28 Typical High $104.71 | Professional | 55 · Aftercare only | $48.98 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $54.95 Typical High $70.79 | Professional | 56 · Pre-op care only | $33.11 | $54.95 | $70.79 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $275.42 Typical High $354.81 | Professional | 52 · Reduced service | $204.17 | $275.42 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $109.65 Typical High $141.25 | Professional | 53 · Discontinued | $81.28 | $109.65 | $141.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $83.18 Typical High $107.15 | Professional | 55 · Aftercare only | $61.66 | $83.18 | $107.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $54.95 Typical High $70.79 | Professional | 56 · Pre-op care only | $40.74 | $54.95 | $70.79 |
Where Texas sits
The same service costs 7.6 times more in Colorado than in Rhode Island. 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· 38th of 51
$174
CO $912RI $120
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.