How much rates vary
Facilitymedian $562 · 10th to 90th $562 to $631Professionalmedian $501 · 10th to 90th $355 to $5,012
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 $338.84 Median $338.84 Typical High $354.81 | Facility | None | $338.84 | $338.84 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $933.25 | Professional | None | $338.84 | $354.81 | $933.25 |
Ambetter Setting Professional Modifier None Typical Low $457.09 Median $851.14 Typical High $912.01 | Professional | None | $457.09 | $851.14 | $912.01 |
BCBS Texas Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $707.95 | Professional | None | $436.52 | $436.52 | $707.95 |
Christus Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $707.95 | Facility | None | $630.96 | $630.96 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $630.96 | Professional | None | $467.74 | $467.74 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $4,466.84 Median $5,011.87 Typical High $5,011.87 | Professional | None | $4,466.84 | $5,011.87 | $5,011.87 |
Moda Health Setting Facility Modifier None Typical Low $354.81 Median $575.44 Typical High $602.56 | Facility | None | $354.81 | $575.44 | $602.56 |
Moda Health Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $933.25 | Professional | None | $338.84 | $354.81 | $933.25 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $630.96 Typical High $630.96 | Professional | None | $81.28 | $630.96 | $630.96 |
Oscar Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
Providence Setting Facility Modifier None Typical Low $426.58 Median $630.96 Typical High $630.96 | Facility | None | $426.58 | $630.96 | $630.96 |
Providence Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $630.96 | Professional | None | $467.74 | $467.74 | $630.96 |
United Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $954.99 | Facility | None | $812.83 | $812.83 | $954.99 |
United Setting Professional Modifier None Typical Low $346.74 Median $562.34 Typical High $776.25 | Professional | None | $346.74 | $562.34 | $776.25 |
Wellpoint Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $691.83 | Professional | None | $602.56 | $691.83 | $691.83 |
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 $169.82 Median $177.83 Typical High $223.87 | Professional | 52 · Reduced service | $169.82 | $177.83 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $70.79 Typical High $89.13 | Professional | 53 · Discontinued | $67.61 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $52.48 Typical High $66.07 | Professional | 55 · Aftercare only | $51.29 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $35.48 Typical High $44.67 | Professional | 56 · Pre-op care only | $33.88 | $35.48 | $44.67 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $177.83 Typical High $218.78 | Professional | 52 · Reduced service | $169.82 | $177.83 | $218.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $70.79 Typical High $87.10 | Professional | 53 · Discontinued | $67.61 | $70.79 | $87.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $52.48 Typical High $66.07 | Professional | 55 · Aftercare only | $51.29 | $52.48 | $66.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $35.48 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.88 | $35.48 | $43.65 |
Where Texas sits
The same service costs 2.2 times more in Kansas 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· 34th of 51
$562
KS $1,000UT $457
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.