How much rates vary
Facilitymedian $759 · 10th to 90th $251 to $759Professionalmedian $550 · 10th to 90th $427 to $5,248
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 $407.38 Median $407.38 Typical High $426.58 | Facility | None | $407.38 | $407.38 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $691.83 | Professional | None | $407.38 | $426.58 | $691.83 |
BCBS Texas Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $630.96 | Professional | None | $489.78 | $489.78 | $630.96 |
Christus Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $758.58 | Professional | None | $549.54 | $549.54 | $758.58 |
Lucent Health Setting Professional Modifier None Typical Low $5,128.61 Median $5,248.07 Typical High $5,248.07 | Professional | None | $5,128.61 | $5,248.07 | $5,248.07 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $630.96 Typical High $758.58 | Facility | None | $251.19 | $630.96 | $758.58 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $707.95 | Professional | None | $407.38 | $426.58 | $707.95 |
Oscar Health Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $758.58 Typical High $758.58 | Facility | None | $251.19 | $758.58 | $758.58 |
Providence Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $758.58 | Professional | None | $549.54 | $549.54 | $758.58 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,230.27 | Facility | None | $1,047.13 | $1,047.13 | $1,230.27 |
United Setting Professional Modifier None Typical Low $389.05 Median $616.60 Typical High $870.96 | Professional | None | $389.05 | $616.60 | $870.96 |
Wellpoint Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
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 $204.17 Median $213.80 Typical High $263.03 | Professional | 52 · Reduced service | $204.17 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $85.11 Typical High $107.15 | Professional | 53 · Discontinued | $81.28 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $79.43 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $42.66 Typical High $53.70 | Professional | 56 · Pre-op care only | $40.74 | $42.66 | $53.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $213.80 Typical High $251.19 | Professional | 52 · Reduced service | $204.17 | $213.80 | $251.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $85.11 Typical High $100.00 | Professional | 53 · Discontinued | $81.28 | $85.11 | $100.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $74.13 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $74.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $42.66 Typical High $50.12 | Professional | 56 · Pre-op care only | $40.74 | $42.66 | $50.12 |
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· 46th of 51
$550
HI $1,230UT $479
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.