How much rates vary
Facilitymedian $1,288 · 10th to 90th $933 to $2,188Professionalmedian $1,202 · 10th to 90th $933 to $19,055
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 $977.24 Median $977.24 Typical High $1,000.00 | Facility | None | $977.24 | $977.24 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,258.93 | Professional | None | $954.99 | $1,000.00 | $1,258.93 |
BCBS Texas Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,023.29 | $1,288.25 | $1,288.25 |
Christus Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Facility | None | $2,187.76 | $2,187.76 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,288.25 | Professional | None | $933.25 | $933.25 | $1,288.25 |
Lucent Health Setting Professional Modifier None Typical Low $12,302.69 Median $19,054.61 Typical High $19,054.61 | Professional | None | $12,302.69 | $19,054.61 | $19,054.61 |
Moda Health Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $2,187.76 | Facility | None | $602.56 | $1,230.27 | $2,187.76 |
Moda Health Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,318.26 | Professional | None | $954.99 | $1,000.00 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $1,258.93 Typical High $1,258.93 | Professional | None | $81.28 | $1,258.93 | $1,258.93 |
Providence Setting Facility Modifier None Typical Low $933.25 Median $1,288.25 Typical High $2,187.76 | Facility | None | $933.25 | $1,288.25 | $2,187.76 |
Providence Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,288.25 | Professional | None | $933.25 | $933.25 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $2,187.76 | Facility | None | $1,258.93 | $1,318.26 | $2,187.76 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,348.96 | Professional | None | $724.44 | $1,047.13 | $1,348.96 |
Wellpoint Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
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 $478.63 Median $501.19 Typical High $616.60 | Professional | 52 · Reduced service | $478.63 | $501.19 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $199.53 Typical High $251.19 | Professional | 53 · Discontinued | $190.55 | $199.53 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $186.21 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $100.00 Typical High $123.03 | Professional | 56 · Pre-op care only | $95.50 | $100.00 | $123.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $501.19 Typical High $602.56 | Professional | 52 · Reduced service | $478.63 | $501.19 | $602.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $199.53 Typical High $239.88 | Professional | 53 · Discontinued | $190.55 | $199.53 | $239.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $181.97 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $181.97 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $100.00 Typical High $120.23 | Professional | 56 · Pre-op care only | $95.50 | $100.00 | $120.23 |
Where Texas sits
The same service costs 3.2 times more in Hawaii than in Alabama. 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· 31st of 51
$1,202
HI $3,020AL $933
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.