How much rates vary
Facilitymedian $331 · 10th to 90th $135 to $617Professionalmedian $129 · 10th to 90th $123 to $132
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 $128.82 Median $208.93 Typical High $281.84 | Facility | None | $128.82 | $208.93 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $131.83 Typical High $144.54 | Professional | None | $128.82 | $131.83 | $144.54 |
BCBS Texas Setting Facility Modifier None Typical Low $147.91 Median $363.08 Typical High $645.65 | Facility | None | $147.91 | $363.08 | $645.65 |
BCBS Texas Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $245.47 Typical High $416.87 | Facility | None | $128.82 | $245.47 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Moda Health Setting Facility Modifier None Typical Low $128.82 Median $169.82 Typical High $269.15 | Facility | None | $128.82 | $169.82 | $269.15 |
Moda Health Setting Professional Modifier None Typical Low $128.82 Median $131.83 Typical High $144.54 | Professional | None | $128.82 | $131.83 | $144.54 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Providence Setting Facility Modifier None Typical Low $128.82 Median $186.21 Typical High $1,122.02 | Facility | None | $128.82 | $186.21 | $1,122.02 |
Providence Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
United Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
United Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Wellpoint Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
12 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 Facility Modifier 52 · Reduced service Typical Low $64.57 Median $104.71 Typical High $141.25 | Facility | 52 · Reduced service | $64.57 | $104.71 | $141.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $25.70 Median $41.69 Typical High $56.23 | Facility | 53 · Discontinued | $25.70 | $41.69 | $56.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.50 Median $30.90 Typical High $42.66 | Facility | 55 · Aftercare only | $19.50 | $30.90 | $42.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.88 Median $20.89 Typical High $28.18 | Facility | 56 · Pre-op care only | $12.88 | $20.89 | $28.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $66.07 Typical High $70.79 | Professional | 52 · Reduced service | $64.57 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $26.30 Typical High $28.84 | Professional | 53 · Discontinued | $25.70 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $21.38 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.18 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.88 | $13.18 | $14.45 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $66.07 Typical High $67.61 | Professional | 52 · Reduced service | $64.57 | $66.07 | $67.61 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $26.30 Typical High $26.92 | Professional | 53 · Discontinued | $25.70 | $26.30 | $26.92 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $20.42 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $20.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.18 Typical High $13.49 | Professional | 56 · Pre-op care only | $12.88 | $13.18 | $13.49 |
Where Texas sits
The same service costs 1.6 times more in Texas than in North Carolina. 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· 1st of 51
$204
TX $204NC $129
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.