How much rates vary
Facilitymedian $776 · 10th to 90th $331 to $1,479Professionalmedian $398 · 10th to 90th $389 to $407
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 $398.11 Median $588.84 Typical High $851.14 | Facility | None | $398.11 | $588.84 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $446.68 | Professional | None | $398.11 | $407.38 | $446.68 |
BCBS Texas Setting Facility Modifier None Typical Low $323.59 Median $794.33 Typical High $1,513.56 | Facility | None | $323.59 | $794.33 | $1,513.56 |
BCBS Texas Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $758.58 Typical High $1,288.25 | Facility | None | $398.11 | $758.58 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $186.21 Median $562.34 Typical High $954.99 | Facility | None | $186.21 | $562.34 | $954.99 |
Moda Health Setting Professional Modifier None Typical Low $389.05 Median $398.11 Typical High $426.58 | Professional | None | $389.05 | $398.11 | $426.58 |
Molina Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Providence Setting Facility Modifier None Typical Low $331.13 Median $489.78 Typical High $3,467.37 | Facility | None | $331.13 | $489.78 | $3,467.37 |
Providence Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
United Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Wellpoint Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
13 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 $199.53 Median $309.03 Typical High $426.58 | Facility | 52 · Reduced service | $199.53 | $309.03 | $426.58 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $79.43 Median $125.89 Typical High $169.82 | Facility | 53 · Discontinued | $79.43 | $125.89 | $169.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $60.26 Median $93.33 Typical High $128.82 | Facility | 55 · Aftercare only | $60.26 | $93.33 | $128.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $39.81 Median $63.10 Typical High $85.11 | Facility | 56 · Pre-op care only | $39.81 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $204.17 Typical High $218.78 | Professional | 52 · Reduced service | $199.53 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $81.28 Typical High $89.13 | Professional | 53 · Discontinued | $79.43 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $66.07 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $40.74 Typical High $44.67 | Professional | 56 · Pre-op care only | $39.81 | $40.74 | $44.67 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $741.31 Median $912.01 Typical High $1,905.46 | Facility | JZ · No drug discarded | $741.31 | $912.01 | $1,905.46 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $199.53 Typical High $204.17 | Professional | 52 · Reduced service | $194.98 | $199.53 | $204.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $79.43 Typical High $81.28 | Professional | 53 · Discontinued | $77.62 | $79.43 | $81.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $61.66 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $61.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $39.81 Typical High $40.74 | Professional | 56 · Pre-op care only | $38.90 | $39.81 | $40.74 |
Where Texas sits
The same service costs 2.8 times more in Arizona than in Alabama. 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· 3rd of 51
$537
AZ $646AL $234
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.