How much rates vary
Facilitymedian $209 · 10th to 90th $117 to $234Professionalmedian $162 · 10th to 90th $120 to $1,698
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 $117.49 Median $117.49 Typical High $120.23 | Facility | None | $117.49 | $117.49 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $151.36 | Professional | None | $117.49 | $120.23 | $151.36 |
BCBS Texas Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $190.55 | Professional | None | $147.91 | $190.55 | $190.55 |
Christus Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | None | $158.49 | $158.49 | $213.80 |
Lucent Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $199.53 Typical High $251.19 | Facility | None | $104.71 | $199.53 | $251.19 |
Moda Health Setting Professional Modifier None Typical Low $117.49 Median $120.23 Typical High $204.17 | Professional | None | $117.49 | $120.23 | $204.17 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $204.17 Typical High $204.17 | Professional | None | $81.28 | $204.17 | $204.17 |
Oscar Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Providence Setting Facility Modifier None Typical Low $120.23 Median $208.93 Typical High $218.78 | Facility | None | $120.23 | $208.93 | $218.78 |
Providence Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | None | $158.49 | $158.49 | $213.80 |
United Setting Facility Modifier None Typical Low $213.80 Median $234.42 Typical High $346.74 | Facility | None | $213.80 | $234.42 | $346.74 |
United Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $234.42 | Professional | None | $109.65 | $177.83 | $234.42 |
Wellpoint Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
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 $57.54 Median $60.26 Typical High $75.86 | Professional | 52 · Reduced service | $57.54 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.99 Typical High $30.90 | Professional | 53 · Discontinued | $23.44 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $18.20 Typical High $22.91 | Professional | 55 · Aftercare only | $17.38 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.02 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.75 | $12.02 | $15.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $60.26 Typical High $75.86 | Professional | 52 · Reduced service | $57.54 | $60.26 | $75.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.99 Typical High $30.90 | Professional | 53 · Discontinued | $23.44 | $23.99 | $30.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $18.20 Typical High $22.91 | Professional | 55 · Aftercare only | $17.38 | $18.20 | $22.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.02 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.75 | $12.02 | $15.14 |
Where Texas sits
The same service costs 2.9 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· 33rd of 51
$191
HI $437UT $151
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.