How much rates vary
Facilitymedian $245 · 10th to 90th $148 to $417Professionalmedian $234 · 10th to 90th $178 to $3,236
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 $181.97 Median $181.97 Typical High $190.55 | Facility | None | $181.97 | $181.97 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $190.55 Typical High $234.42 | Professional | None | $177.83 | $190.55 | $234.42 |
BCBS Texas Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Christus 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 Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Lucent Health Setting Professional Modifier None Typical Low $2,570.40 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,570.40 | $3,235.94 | $3,235.94 |
Moda Health Setting Facility Modifier None Typical Low $125.89 Median $229.09 Typical High $416.87 | Facility | None | $125.89 | $229.09 | $416.87 |
Moda Health Setting Professional Modifier None Typical Low $177.83 Median $190.55 Typical High $316.23 | Professional | None | $177.83 | $190.55 | $316.23 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $234.42 Typical High $234.42 | Professional | None | $81.28 | $234.42 | $234.42 |
Providence Setting Facility Modifier None Typical Low $173.78 Median $245.47 Typical High $416.87 | Facility | None | $173.78 | $245.47 | $416.87 |
Providence Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
United Setting Facility Modifier None Typical Low $147.91 Median $204.17 Typical High $457.09 | Facility | None | $147.91 | $204.17 | $457.09 |
United Setting Professional Modifier None Typical Low $151.36 Median $218.78 Typical High $281.84 | Professional | None | $151.36 | $218.78 | $281.84 |
Wellpoint Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
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 $89.13 Median $95.50 Typical High $117.49 | Professional | 52 · Reduced service | $89.13 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.02 Typical High $46.77 | Professional | 53 · Discontinued | $35.48 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.18 Typical High $35.48 | Professional | 55 · Aftercare only | $26.92 | $28.18 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.05 Typical High $23.44 | Professional | 56 · Pre-op care only | $17.78 | $19.05 | $23.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $95.50 Typical High $117.49 | Professional | 52 · Reduced service | $89.13 | $95.50 | $117.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.02 Typical High $46.77 | Professional | 53 · Discontinued | $35.48 | $38.02 | $46.77 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.18 Typical High $35.48 | Professional | 55 · Aftercare only | $26.92 | $28.18 | $35.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.05 Typical High $23.44 | Professional | 56 · Pre-op care only | $17.78 | $19.05 | $23.44 |
Where Texas sits
The same service costs 2.9 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· 40th of 51
$234
MT $513DE $178
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.