How much rates vary
Facilitymedian $224 · 10th to 90th $178 to $269Professionalmedian $170 · 10th to 90th $129 to $2,042
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 $158.49 Median $158.49 Typical High $165.96 | Facility | None | $158.49 | $158.49 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $275.42 | Professional | None | $151.36 | $165.96 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $27.54 Median $269.15 Typical High $269.15 | Professional | None | $27.54 | $269.15 | $269.15 |
BCBS Texas Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $213.80 | Professional | None | $169.82 | $169.82 | $213.80 |
Christus Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $190.55 | Facility | None | $177.83 | $177.83 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | None | $128.82 | $128.82 | $177.83 |
Lucent Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,905.46 | $2,041.74 | $2,041.74 |
Moda Health Setting Facility Modifier None Typical Low $85.11 Median $199.53 Typical High $363.08 | Facility | None | $85.11 | $199.53 | $363.08 |
Moda Health Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $288.40 | Professional | None | $151.36 | $165.96 | $288.40 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $190.55 Typical High $190.55 | Professional | None | $81.28 | $190.55 | $190.55 |
Providence Setting Facility Modifier None Typical Low $151.36 Median $177.83 Typical High $363.08 | Facility | None | $151.36 | $177.83 | $363.08 |
Providence Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | None | $128.82 | $128.82 | $177.83 |
United Setting Facility Modifier None Typical Low $177.83 Median $186.21 Typical High $309.03 | Facility | None | $177.83 | $186.21 | $309.03 |
United Setting Professional Modifier None Typical Low $102.33 Median $147.91 Typical High $190.55 | Professional | None | $102.33 | $147.91 | $190.55 |
Wellpoint Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $158.49 | Professional | None | $128.82 | $128.82 | $158.49 |
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 $75.86 Median $83.18 Typical High $97.72 | Professional | 52 · Reduced service | $75.86 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $33.11 Typical High $39.81 | Professional | 53 · Discontinued | $30.20 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $24.55 Typical High $29.51 | Professional | 55 · Aftercare only | $22.91 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.60 Typical High $19.95 | Professional | 56 · Pre-op care only | $15.14 | $16.60 | $19.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $81.28 Typical High $95.50 | Professional | 52 · Reduced service | $75.86 | $81.28 | $95.50 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $32.36 Typical High $38.02 | Professional | 53 · Discontinued | $30.20 | $32.36 | $38.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $24.55 Typical High $28.18 | Professional | 55 · Aftercare only | $22.91 | $24.55 | $28.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.22 Typical High $19.05 | Professional | 56 · Pre-op care only | $15.14 | $16.22 | $19.05 |
Where Texas sits
The same service costs 3.5 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· 29th of 51
$170
HI $457DE $129
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.