How much rates vary
Facilitymedian $708 · 10th to 90th $437 to $1,047Professionalmedian $617 · 10th to 90th $457 to $10,471
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 $457.09 Median $457.09 Typical High $478.63 | Facility | None | $457.09 | $457.09 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $831.76 | Professional | None | $446.68 | $478.63 | $831.76 |
Ambetter Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $794.33 | Professional | None | $616.60 | $794.33 | $794.33 |
BCBS Texas Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $616.60 | Professional | None | $489.78 | $489.78 | $616.60 |
Christus Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $776.25 | Facility | None | $707.95 | $707.95 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $707.95 | Professional | None | $512.86 | $512.86 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $7,079.46 Median $10,471.29 Typical High $10,471.29 | Professional | None | $7,079.46 | $10,471.29 | $10,471.29 |
Moda Health Setting Facility Modifier None Typical Low $331.13 Median $575.44 Typical High $1,047.13 | Facility | None | $331.13 | $575.44 | $1,047.13 |
Moda Health Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $831.76 | Professional | None | $446.68 | $478.63 | $831.76 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $549.54 Typical High $549.54 | Professional | None | $81.28 | $549.54 | $549.54 |
Providence Setting Facility Modifier None Typical Low $436.52 Median $707.95 Typical High $1,047.13 | Facility | None | $436.52 | $707.95 | $1,047.13 |
Providence Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $707.95 | Professional | None | $512.86 | $512.86 | $707.95 |
United Setting Facility Modifier None Typical Low $478.63 Median $691.83 Typical High $1,174.90 | Facility | None | $478.63 | $691.83 | $1,174.90 |
United Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $741.31 | Professional | None | $398.11 | $549.54 | $741.31 |
Wellpoint Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
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 $223.87 Median $239.88 Typical High $295.12 | Professional | 52 · Reduced service | $223.87 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $95.50 Typical High $120.23 | Professional | 53 · Discontinued | $89.13 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $70.79 Typical High $89.13 | Professional | 55 · Aftercare only | $67.61 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $47.86 Typical High $60.26 | Professional | 56 · Pre-op care only | $44.67 | $47.86 | $60.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $239.88 Typical High $295.12 | Professional | 52 · Reduced service | $223.87 | $239.88 | $295.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $95.50 Typical High $117.49 | Professional | 53 · Discontinued | $89.13 | $95.50 | $117.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $70.79 Typical High $89.13 | Professional | 55 · Aftercare only | $67.61 | $70.79 | $89.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $47.86 Typical High $58.88 | Professional | 56 · Pre-op care only | $44.67 | $47.86 | $58.88 |
Where Texas sits
The same service costs 3.4 times more in Hawaii than in Mississippi. 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· 40th of 51
$617
HI $1,738MS $513
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.