How much rates vary
Facilitymedian $1,047 · 10th to 90th $447 to $2,042Professionalmedian $479 · 10th to 90th $468 to $501
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 $489.78 Median $794.33 Typical High $1,071.52 | Facility | None | $489.78 | $794.33 | $1,071.52 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $501.19 Typical High $537.03 | Professional | None | $489.78 | $501.19 | $537.03 |
BCBS Texas Setting Facility Modifier None Typical Low $446.68 Median $1,096.48 Typical High $2,041.74 | Facility | None | $446.68 | $1,096.48 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $707.95 Typical High $1,513.56 | Facility | None | $478.63 | $707.95 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Moda Health Setting Facility Modifier None Typical Low $158.49 Median $549.54 Typical High $1,023.29 | Facility | None | $158.49 | $549.54 | $1,023.29 |
Moda Health Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $501.19 | Professional | None | $478.63 | $501.19 | $501.19 |
Molina Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Providence Setting Facility Modifier None Typical Low $446.68 Median $575.44 Typical High $4,073.80 | Facility | None | $446.68 | $575.44 | $4,073.80 |
Providence Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
United Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Wellpoint Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
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 $245.47 Median $398.11 Typical High $537.03 | Facility | 52 · Reduced service | $245.47 | $398.11 | $537.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $97.72 Median $158.49 Typical High $213.80 | Facility | 53 · Discontinued | $97.72 | $158.49 | $213.80 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $74.13 Median $117.49 Typical High $162.18 | Facility | 55 · Aftercare only | $74.13 | $117.49 | $162.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $48.98 Median $79.43 Typical High $107.15 | Facility | 56 · Pre-op care only | $48.98 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $251.19 Typical High $263.03 | Professional | 52 · Reduced service | $245.47 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $100.00 Typical High $107.15 | Professional | 53 · Discontinued | $97.72 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $79.43 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $50.12 Typical High $53.70 | Professional | 56 · Pre-op care only | $48.98 | $50.12 | $53.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $245.47 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $97.72 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $74.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $48.98 | $50.12 | $50.12 |
Where Texas sits
The same service costs 2.3 times more in Arizona than in Idaho. 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· 4th of 51
$708
AZ $832ID $355
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.