How much rates vary
Facilitymedian $741 · 10th to 90th $550 to $1,288Professionalmedian $646 · 10th to 90th $513 to $8,913
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 $562.34 Median $562.34 Typical High $588.84 | Facility | None | $562.34 | $562.34 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $691.83 | Professional | None | $562.34 | $588.84 | $691.83 |
BCBS Texas Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Christus 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 Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $741.31 | Professional | None | $537.03 | $537.03 | $741.31 |
Lucent Health Setting Professional Modifier None Typical Low $6,760.83 Median $8,912.51 Typical High $8,912.51 | Professional | None | $6,760.83 | $8,912.51 | $8,912.51 |
Moda Health Setting Facility Modifier None Typical Low $331.13 Median $724.44 Typical High $1,288.25 | Facility | None | $331.13 | $724.44 | $1,288.25 |
Moda Health Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $812.83 | Professional | None | $549.54 | $588.84 | $812.83 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $645.65 Typical High $645.65 | Professional | None | $81.28 | $645.65 | $645.65 |
Oscar Health Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
Providence Setting Facility Modifier None Typical Low $549.54 Median $741.31 Typical High $1,288.25 | Facility | None | $549.54 | $741.31 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $741.31 | Professional | None | $537.03 | $537.03 | $741.31 |
United Setting Facility Modifier None Typical Low $645.65 Median $691.83 Typical High $1,202.26 | Facility | None | $645.65 | $691.83 | $1,202.26 |
United Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $741.31 | Professional | None | $398.11 | $575.44 | $741.31 |
Wellpoint Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
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 $281.84 Median $295.12 Typical High $346.74 | Professional | 52 · Reduced service | $281.84 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $117.49 Typical High $138.04 | Professional | 53 · Discontinued | $112.20 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $89.13 Typical High $102.33 | Professional | 55 · Aftercare only | $83.18 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $58.88 Typical High $69.18 | Professional | 56 · Pre-op care only | $56.23 | $58.88 | $69.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $288.40 Typical High $346.74 | Professional | 52 · Reduced service | $281.84 | $288.40 | $346.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $114.82 Typical High $138.04 | Professional | 53 · Discontinued | $112.20 | $114.82 | $138.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $87.10 Typical High $102.33 | Professional | 55 · Aftercare only | $83.18 | $87.10 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $57.54 Typical High $69.18 | Professional | 56 · Pre-op care only | $56.23 | $57.54 | $69.18 |
Where Texas sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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· 26th of 51
$661
HI $1,622VT $537
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.