How much rates vary
Facilitymedian $316 · 10th to 90th $245 to $575Professionalmedian $302 · 10th to 90th $229 to $4,169
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 $251.19 Median $251.19 Typical High $263.03 | Facility | None | $251.19 | $251.19 | $263.03 |
Aetna Setting Professional Modifier None (both parts) Typical Low $251.19 Median $263.03 Typical High $457.09 | Professional | None (both parts) | $251.19 | $263.03 | $457.09 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $288.40 Median $446.68 Typical High $446.68 | Professional | None (both parts) | $288.40 | $446.68 | $446.68 |
BCBS Texas Setting Professional Modifier None (both parts) Typical Low $269.15 Median $269.15 Typical High $338.84 | Professional | None (both parts) | $269.15 | $269.15 | $338.84 |
Baylor Scott & White Setting Professional Modifier None (both parts) Typical Low $436.52 Median $436.52 Typical High $575.44 | Professional | None (both parts) | $436.52 | $436.52 | $575.44 |
Christus Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Professional Modifier None (both parts) Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None (both parts) | $229.09 | $229.09 | $316.23 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $2,884.03 Median $4,168.69 Typical High $4,168.69 | Professional | None (both parts) | $2,884.03 | $4,168.69 | $4,168.69 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $316.23 Typical High $575.44 | Facility | None | $162.18 | $316.23 | $575.44 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $251.19 Median $263.03 Typical High $457.09 | Professional | None (both parts) | $251.19 | $263.03 | $457.09 |
Molina Setting Professional Modifier None (both parts) Typical Low $81.28 Median $380.19 Typical High $380.19 | Professional | None (both parts) | $81.28 | $380.19 | $380.19 |
Providence Setting Facility Modifier None Typical Low $245.47 Median $316.23 Typical High $575.44 | Facility | None | $245.47 | $316.23 | $575.44 |
Providence Setting Professional Modifier None (both parts) Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None (both parts) | $229.09 | $229.09 | $316.23 |
United Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $691.83 | Facility | None | $588.84 | $588.84 | $691.83 |
United Setting Professional Modifier None (both parts) Typical Low $194.98 Median $281.84 Typical High $363.08 | Professional | None (both parts) | $194.98 | $281.84 | $363.08 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $234.42 Median $234.42 Typical High $302.00 | Professional | None (both parts) | $234.42 | $234.42 | $302.00 |
9 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 $123.03 Median $131.83 Typical High $162.18 | Professional | 52 · Reduced service | $123.03 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $52.48 Typical High $64.57 | Professional | 53 · Discontinued | $50.12 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $39.81 Typical High $48.98 | Professional | 55 · Aftercare only | $37.15 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.30 Typical High $32.36 | Professional | 56 · Pre-op care only | $25.12 | $26.30 | $32.36 |
Christus Setting Professional Modifier 26 · Professional part Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 26 · Professional part | $380.19 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $131.83 Typical High $158.49 | Professional | 52 · Reduced service | $123.03 | $131.83 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $52.48 Typical High $63.10 | Professional | 53 · Discontinued | $50.12 | $52.48 | $63.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $39.81 Typical High $47.86 | Professional | 55 · Aftercare only | $37.15 | $39.81 | $47.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.30 Typical High $31.62 | Professional | 56 · Pre-op care only | $25.12 | $26.30 | $31.62 |
Where Texas sits
The same service costs 2.6 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· 32nd of 51
$309
MT $589DE $229
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.