How much rates vary
Facilitymedian $219 · 10th to 90th $145 to $347Professionalmedian $182 · 10th to 90th $148 to $2,884
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 $151.36 Median $151.36 Typical High $158.49 | Facility | None | $151.36 | $151.36 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $158.49 Typical High $194.98 | Professional | None | $147.91 | $158.49 | $194.98 |
BCBS Texas Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $204.17 | Professional | None | $162.18 | $204.17 | $204.17 |
Christus Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Lucent Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,187.76 | $2,884.03 | $2,884.03 |
Moda Health Setting Facility Modifier None Typical Low $97.72 Median $190.55 Typical High $346.74 | Facility | None | $97.72 | $190.55 | $346.74 |
Moda Health Setting Professional Modifier None Typical Low $147.91 Median $158.49 Typical High $257.04 | Professional | None | $147.91 | $158.49 | $257.04 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $173.78 Typical High $173.78 | Professional | None | $81.28 | $173.78 | $173.78 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $218.78 Typical High $346.74 | Facility | None | $144.54 | $218.78 | $346.74 |
Providence Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
United Setting Facility Modifier None Typical Low $199.53 Median $204.17 Typical High $346.74 | Facility | None | $199.53 | $204.17 | $346.74 |
United Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $213.80 | Professional | None | $114.82 | $165.96 | $213.80 |
Wellpoint Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
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 $74.13 Median $79.43 Typical High $97.72 | Professional | 52 · Reduced service | $74.13 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $31.62 Typical High $38.90 | Professional | 53 · Discontinued | $29.51 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $23.44 Typical High $29.51 | Professional | 55 · Aftercare only | $22.39 | $23.44 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.85 Typical High $19.50 | Professional | 56 · Pre-op care only | $14.79 | $15.85 | $19.50 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $79.43 Typical High $93.33 | Professional | 52 · Reduced service | $74.13 | $79.43 | $93.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $31.62 Typical High $38.02 | Professional | 53 · Discontinued | $29.51 | $31.62 | $38.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $23.44 Typical High $28.18 | Professional | 55 · Aftercare only | $22.39 | $23.44 | $28.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.85 Typical High $19.05 | Professional | 56 · Pre-op care only | $14.79 | $15.85 | $19.05 |
Where Texas sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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
$186
HI $525WV $158
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.