How much rates vary
Facilitymedian $417 · 10th to 90th $295 to $692Professionalmedian $380 · 10th to 90th $302 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 $302.00 Median $302.00 Typical High $316.23 | Facility | None | $302.00 | $302.00 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $416.87 | Professional | None | $295.12 | $316.23 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
BCBS Texas Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $407.38 | Professional | None | $323.59 | $323.59 | $407.38 |
Christus Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None | $309.03 | $309.03 | $416.87 |
Lucent Health Setting Professional Modifier None Typical Low $3,467.37 Median $5,011.87 Typical High $5,011.87 | Professional | None | $3,467.37 | $5,011.87 | $5,011.87 |
Moda Health Setting Facility Modifier None Typical Low $194.98 Median $380.19 Typical High $691.83 | Facility | None | $194.98 | $380.19 | $691.83 |
Moda Health Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $549.54 | Professional | None | $295.12 | $316.23 | $549.54 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $446.68 Typical High $446.68 | Professional | None | $81.28 | $446.68 | $446.68 |
Oscar Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Providence Setting Facility Modifier None Typical Low $295.12 Median $416.87 Typical High $691.83 | Facility | None | $295.12 | $416.87 | $691.83 |
Providence Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None | $309.03 | $309.03 | $416.87 |
United Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $831.76 | Facility | None | $707.95 | $707.95 | $831.76 |
United Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $436.52 | Professional | None | $234.42 | $338.84 | $436.52 |
Wellpoint Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
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 $147.91 Median $158.49 Typical High $194.98 | Professional | 52 · Reduced service | $147.91 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $63.10 Typical High $77.62 | Professional | 53 · Discontinued | $60.26 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $47.86 Typical High $58.88 | Professional | 55 · Aftercare only | $44.67 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $31.62 Typical High $38.90 | Professional | 56 · Pre-op care only | $29.51 | $31.62 | $38.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $158.49 Typical High $190.55 | Professional | 52 · Reduced service | $147.91 | $158.49 | $190.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $63.10 Typical High $75.86 | Professional | 53 · Discontinued | $60.26 | $63.10 | $75.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $47.86 Typical High $56.23 | Professional | 55 · Aftercare only | $44.67 | $47.86 | $56.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $31.62 Typical High $38.02 | Professional | 56 · Pre-op care only | $29.51 | $31.62 | $38.02 |
Where Texas sits
The same service costs 2.2 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· 39th of 51
$380
MT $692DE $309
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.