How much rates vary
Facilitymedian $550 · 10th to 90th $331 to $813Professionalmedian $479 · 10th to 90th $363 to $8,128
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 $354.81 Median $354.81 Typical High $371.54 | Facility | None | $354.81 | $354.81 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $371.54 Typical High $645.65 | Professional | None | $354.81 | $371.54 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $616.60 | Professional | None | $575.44 | $616.60 | $616.60 |
BCBS Texas Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $478.63 | Professional | None | $380.19 | $380.19 | $478.63 |
Baylor Scott & White Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $812.83 | Professional | None | $616.60 | $616.60 | $812.83 |
Christus Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $549.54 | Professional | None | $398.11 | $398.11 | $549.54 |
Lucent Health Setting Professional Modifier None Typical Low $5,248.07 Median $8,128.31 Typical High $8,128.31 | Professional | None | $5,248.07 | $8,128.31 | $8,128.31 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $446.68 Typical High $812.83 | Facility | None | $257.04 | $446.68 | $812.83 |
Moda Health Setting Professional Modifier None Typical Low $354.81 Median $371.54 Typical High $645.65 | Professional | None | $354.81 | $371.54 | $645.65 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $426.58 Typical High $426.58 | Professional | None | $81.28 | $426.58 | $426.58 |
Providence Setting Facility Modifier None Typical Low $346.74 Median $549.54 Typical High $812.83 | Facility | None | $346.74 | $549.54 | $812.83 |
Providence Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $549.54 | Professional | None | $398.11 | $398.11 | $549.54 |
United Setting Facility Modifier None Typical Low $331.13 Median $436.52 Typical High $933.25 | Facility | None | $331.13 | $436.52 | $933.25 |
United Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $575.44 | Professional | None | $309.03 | $436.52 | $575.44 |
Wellpoint Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
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 $173.78 Median $186.21 Typical High $234.42 | Professional | 52 · Reduced service | $173.78 | $186.21 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $74.13 Typical High $93.33 | Professional | 53 · Discontinued | $70.79 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $56.23 Typical High $70.79 | Professional | 55 · Aftercare only | $52.48 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $37.15 Typical High $46.77 | Professional | 56 · Pre-op care only | $35.48 | $37.15 | $46.77 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $186.21 Typical High $229.09 | Professional | 52 · Reduced service | $173.78 | $186.21 | $229.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $74.13 Typical High $93.33 | Professional | 53 · Discontinued | $70.79 | $74.13 | $93.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $56.23 Typical High $69.18 | Professional | 55 · Aftercare only | $52.48 | $56.23 | $69.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $37.15 Typical High $46.77 | Professional | 56 · Pre-op care only | $35.48 | $37.15 | $46.77 |
Where Texas sits
The same service costs 2.4 times more in Iowa 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· 38th of 51
$479
IA $955DE $398
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.