How much rates vary
Facilitymedian $955 · 10th to 90th $692 to $2,188Professionalmedian $692 · 10th to 90th $692 to $3,020
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 $691.83 Median $831.76 Typical High $1,513.56 | Facility | None | $691.83 | $831.76 | $1,513.56 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $707.95 | Professional | None | $691.83 | $691.83 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,318.26 Typical High $2,187.76 | Facility | None | $691.83 | $1,318.26 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Lucent Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
Moda Health Setting Facility Modifier None Typical Low $691.83 Median $707.95 Typical High $1,047.13 | Facility | None | $691.83 | $707.95 | $1,047.13 |
Moda Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $707.95 | Professional | None | $691.83 | $691.83 | $707.95 |
Molina Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,071.52 | Professional | None | $549.54 | $724.44 | $1,071.52 |
Oscar Health Setting Professional Modifier None Typical Low $741.31 Median $1,230.27 Typical High $2,511.89 | Professional | None | $741.31 | $1,230.27 | $2,511.89 |
Providence Setting Facility Modifier None Typical Low $691.83 Median $977.24 Typical High $5,888.44 | Facility | None | $691.83 | $977.24 | $5,888.44 |
Providence Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
United Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
United Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $776.25 | Professional | None | $691.83 | $724.44 | $776.25 |
Wellpoint Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
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 $338.84 Median $407.38 Typical High $741.31 | Facility | 52 · Reduced service | $338.84 | $407.38 | $741.31 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $138.04 Median $165.96 Typical High $302.00 | Facility | 53 · Discontinued | $138.04 | $165.96 | $302.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $102.33 Median $123.03 Typical High $223.87 | Facility | 55 · Aftercare only | $102.33 | $123.03 | $223.87 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $69.18 Median $83.18 Typical High $151.36 | Facility | 56 · Pre-op care only | $69.18 | $83.18 | $151.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $338.84 Typical High $354.81 | Professional | 52 · Reduced service | $338.84 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $141.25 | Professional | 53 · Discontinued | $138.04 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $104.71 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $70.79 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $70.79 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $346.74 Typical High $354.81 | Professional | 52 · Reduced service | $346.74 | $346.74 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $141.25 | Professional | 53 · Discontinued | $138.04 | $138.04 | $141.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $107.15 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $107.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $70.79 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $70.79 |
Where Texas sits
Rates are fairly even across states for this service. 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· 42nd of 51
$692
AK $832IN $692
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.