How much rates vary
Facilitymedian $417 · 10th to 90th $257 to $617Professionalmedian $347 · 10th to 90th $269 to $4,677
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 $269.15 Median $269.15 Typical High $281.84 | Facility | None | $269.15 | $269.15 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $281.84 Typical High $346.74 | Professional | None | $263.03 | $281.84 | $346.74 |
BCBS Texas Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Christus Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None | $309.03 | $309.03 | $416.87 |
Lucent Health Setting Professional Modifier None Typical Low $3,630.78 Median $4,677.35 Typical High $4,677.35 | Professional | None | $3,630.78 | $4,677.35 | $4,677.35 |
Moda Health Setting Facility Modifier None Typical Low $177.83 Median $338.84 Typical High $616.60 | Facility | None | $177.83 | $338.84 | $616.60 |
Moda Health Setting Professional Modifier None Typical Low $263.03 Median $281.84 Typical High $446.68 | Professional | None | $263.03 | $281.84 | $446.68 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $323.59 Typical High $323.59 | Professional | None | $81.28 | $323.59 | $323.59 |
Oscar Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
Providence Setting Facility Modifier None Typical Low $257.04 Median $416.87 Typical High $616.60 | Facility | None | $257.04 | $416.87 | $616.60 |
Providence Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None | $309.03 | $309.03 | $416.87 |
United Setting Facility Modifier None Typical Low $363.08 Median $371.54 Typical High $645.65 | Facility | None | $363.08 | $371.54 | $645.65 |
United Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $398.11 | Professional | None | $213.80 | $309.03 | $398.11 |
Wellpoint Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
8 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 Professional Modifier 52 · Reduced service Typical Low $131.83 Median $138.04 Typical High $173.78 | Professional | 52 · Reduced service | $131.83 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $56.23 Typical High $69.18 | Professional | 53 · Discontinued | $52.48 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $41.69 Typical High $52.48 | Professional | 55 · Aftercare only | $39.81 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.18 Typical High $34.67 | Professional | 56 · Pre-op care only | $26.30 | $28.18 | $34.67 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $138.04 Typical High $165.96 | Professional | 52 · Reduced service | $131.83 | $138.04 | $165.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $56.23 Typical High $67.61 | Professional | 53 · Discontinued | $52.48 | $56.23 | $67.61 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $41.69 Typical High $50.12 | Professional | 55 · Aftercare only | $39.81 | $41.69 | $50.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.18 Typical High $33.88 | Professional | 56 · Pre-op care only | $26.30 | $28.18 | $33.88 |
Where Texas sits
The same service costs 2.9 times more in Hawaii than in Washington, DC. 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· 29th of 51
$355
HI $871DC $302
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.