How much rates vary
Facilitymedian $251 · 10th to 90th $83 to $275Professionalmedian $214 · 10th to 90th $145 to $1,778
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 $138.04 Median $138.04 Typical High $144.54 | Facility | None | $138.04 | $138.04 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $177.83 | Professional | None | $138.04 | $144.54 | $177.83 |
BCBS Texas Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Christus Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | None | $204.17 | $204.17 | $275.42 |
Lucent Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,737.80 | $1,778.28 | $1,778.28 |
Moda Health Setting Facility Modifier None Typical Low $83.18 Median $204.17 Typical High $251.19 | Facility | None | $83.18 | $204.17 | $251.19 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $181.97 | Professional | None | $138.04 | $144.54 | $181.97 |
Providence Setting Facility Modifier None Typical Low $83.18 Median $275.42 Typical High $275.42 | Facility | None | $83.18 | $275.42 | $275.42 |
Providence Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | None | $204.17 | $204.17 | $275.42 |
United Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $416.87 | Facility | None | $354.81 | $354.81 | $416.87 |
United Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $295.12 | Professional | None | $131.83 | $208.93 | $295.12 |
Wellpoint Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $69.18 Median $72.44 Typical High $89.13 | Professional | 52 · Reduced service | $69.18 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $28.84 Typical High $36.31 | Professional | 53 · Discontinued | $27.54 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $21.88 Typical High $26.92 | Professional | 55 · Aftercare only | $20.89 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $14.45 Typical High $17.78 | Professional | 56 · Pre-op care only | $13.80 | $14.45 | $17.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $72.44 Typical High $83.18 | Professional | 52 · Reduced service | $69.18 | $72.44 | $83.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $28.84 Typical High $33.88 | Professional | 53 · Discontinued | $27.54 | $28.84 | $33.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $21.88 Typical High $25.12 | Professional | 55 · Aftercare only | $20.89 | $21.88 | $25.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $14.45 Typical High $16.98 | Professional | 56 · Pre-op care only | $13.80 | $14.45 | $16.98 |
Where Texas sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 23rd of 51
$234
HI $417UT $162
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.