How much rates vary
Facilitymedian $191 · 10th to 90th $126 to $398Professionalmedian $191 · 10th to 90th $138 to $2,344
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 $173.78 Median $173.78 Typical High $181.97 | Facility | None | $173.78 | $173.78 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $208.93 | Professional | None | $169.82 | $181.97 | $208.93 |
BCBS Texas Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $234.42 | Professional | None | $186.21 | $186.21 | $234.42 |
Christus Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Lucent Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,949.84 | $2,344.23 | $2,344.23 |
Moda Health Setting Facility Modifier None Typical Low $97.72 Median $218.78 Typical High $398.11 | Facility | None | $97.72 | $218.78 | $398.11 |
Moda Health Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $229.09 | Professional | None | $165.96 | $181.97 | $229.09 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $208.93 Typical High $208.93 | Professional | None | $81.28 | $208.93 | $208.93 |
Oscar Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Providence Setting Facility Modifier None Typical Low $165.96 Median $190.55 Typical High $398.11 | Facility | None | $165.96 | $190.55 | $398.11 |
Providence Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
United Setting Facility Modifier None Typical Low $125.89 Median $173.78 Typical High $354.81 | Facility | None | $125.89 | $173.78 | $354.81 |
United Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $218.78 | Professional | None | $117.49 | $169.82 | $218.78 |
Wellpoint Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $85.11 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $85.11 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $36.31 Typical High $42.66 | Professional | 53 · Discontinued | $33.88 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $26.92 Typical High $31.62 | Professional | 55 · Aftercare only | $25.70 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $18.20 Typical High $20.89 | Professional | 56 · Pre-op care only | $16.98 | $18.20 | $20.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $89.13 Typical High $104.71 | Professional | 52 · Reduced service | $85.11 | $89.13 | $104.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $35.48 Typical High $41.69 | Professional | 53 · Discontinued | $33.88 | $35.48 | $41.69 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $26.92 Typical High $31.62 | Professional | 55 · Aftercare only | $25.70 | $26.92 | $31.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $17.78 Typical High $20.89 | Professional | 56 · Pre-op care only | $16.98 | $17.78 | $20.89 |
Where Texas sits
The same service costs 2.7 times more in Hawaii 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· 28th of 51
$191
HI $372DE $138
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.