How much rates vary
Facilitymedian $302 · 10th to 90th $126 to $490Professionalmedian $295 · 10th to 90th $214 to $339
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 $281.84 Median $346.74 Typical High $467.74 | Facility | None | $281.84 | $346.74 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $309.03 | Professional | None | $295.12 | $295.12 | $309.03 |
BCBS Texas Setting Facility Modifier None Typical Low $97.72 Median $263.03 Typical High $489.78 | Facility | None | $97.72 | $263.03 | $489.78 |
BCBS Texas Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Christus Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $562.34 Typical High $933.25 | Facility | None | $295.12 | $562.34 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Moda Health Setting Facility Modifier None Typical Low $6.92 Median $234.42 Typical High $446.68 | Facility | None | $6.92 | $234.42 | $446.68 |
Moda Health Setting Professional Modifier None Typical Low $213.80 Median $218.78 Typical High $281.84 | Professional | None | $213.80 | $218.78 | $281.84 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Providence Setting Facility Modifier None Typical Low $93.33 Median $354.81 Typical High $2,511.89 | Facility | None | $93.33 | $354.81 | $2,511.89 |
Providence Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
United Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Wellpoint Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
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 $141.25 Median $169.82 Typical High $234.42 | Facility | 52 · Reduced service | $141.25 | $169.82 | $234.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $56.23 Median $69.18 Typical High $93.33 | Facility | 53 · Discontinued | $56.23 | $69.18 | $93.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $42.66 Median $51.29 Typical High $70.79 | Facility | 55 · Aftercare only | $42.66 | $51.29 | $70.79 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $28.18 Median $34.67 Typical High $46.77 | Facility | 56 · Pre-op care only | $28.18 | $34.67 | $46.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $147.91 Typical High $154.88 | Professional | 52 · Reduced service | $147.91 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $60.26 Typical High $61.66 | Professional | 53 · Discontinued | $58.88 | $60.26 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $45.71 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $30.90 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $30.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $109.65 Typical High $112.20 | Professional | 52 · Reduced service | $107.15 | $109.65 | $112.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $43.65 Typical High $44.67 | Professional | 53 · Discontinued | $42.66 | $43.65 | $44.67 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $32.36 Typical High $33.88 | Professional | 55 · Aftercare only | $32.36 | $32.36 | $33.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.88 Typical High $22.39 | Professional | 56 · Pre-op care only | $21.38 | $21.88 | $22.39 |
Where Texas sits
The same service costs 6.8 times more in Wyoming than in Oklahoma. 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· 12th of 51
$302
WY $457OK $67.61
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.