How much rates vary
Facilitymedian $437 · 10th to 90th $437 to $708Professionalmedian $389 · 10th to 90th $309 to $5,129
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 $309.03 Median $309.03 Typical High $323.59 | Facility | None | $309.03 | $309.03 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $398.11 | Professional | None | $302.00 | $323.59 | $398.11 |
BCBS Texas Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Christus Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
Lucent Health Setting Professional Modifier None Typical Low $3,548.13 Median $5,128.61 Typical High $5,128.61 | Professional | None | $3,548.13 | $5,128.61 | $5,128.61 |
Moda Health Setting Facility Modifier None Typical Low $323.59 Median $562.34 Typical High $707.95 | Facility | None | $323.59 | $562.34 | $707.95 |
Moda Health Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $457.09 | Professional | None | $302.00 | $323.59 | $457.09 |
Oscar Health Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Providence Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $707.95 | Facility | None | $436.52 | $436.52 | $707.95 |
Providence Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
United Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $851.14 | Facility | None | $707.95 | $707.95 | $851.14 |
United Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $489.78 | Professional | None | $239.88 | $346.74 | $489.78 |
Wellpoint Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
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 $151.36 Median $162.18 Typical High $199.53 | Professional | 52 · Reduced service | $151.36 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $64.57 Typical High $79.43 | Professional | 53 · Discontinued | $61.66 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $48.98 Typical High $60.26 | Professional | 55 · Aftercare only | $45.71 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $32.36 Typical High $39.81 | Professional | 56 · Pre-op care only | $30.20 | $32.36 | $39.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $162.18 Typical High $194.98 | Professional | 52 · Reduced service | $151.36 | $162.18 | $194.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $64.57 Typical High $77.62 | Professional | 53 · Discontinued | $61.66 | $64.57 | $77.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $48.98 Typical High $57.54 | Professional | 55 · Aftercare only | $45.71 | $48.98 | $57.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $32.36 Typical High $38.90 | Professional | 56 · Pre-op care only | $30.20 | $32.36 | $38.90 |
Where Texas sits
The same service costs 2.3 times more in Montana than in Delaware. 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
$398
MT $741DE $316
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.