How much rates vary
Facilitymedian $339 · 10th to 90th $275 to $646Professionalmedian $324 · 10th to 90th $245 to $4,266
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 $281.84 Median $281.84 Typical High $295.12 | Facility | None | $281.84 | $281.84 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $346.74 | Professional | None | $281.84 | $295.12 | $346.74 |
BCBS Texas Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Christus Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $338.84 | Professional | None | $245.47 | $245.47 | $338.84 |
Lucent Health Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $354.81 Typical High $645.65 | Facility | None | $173.78 | $354.81 | $645.65 |
Moda Health Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $389.05 | Professional | None | $281.84 | $295.12 | $389.05 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $363.08 Typical High $363.08 | Professional | None | $81.28 | $363.08 | $363.08 |
Providence Setting Facility Modifier None Typical Low $275.42 Median $338.84 Typical High $645.65 | Facility | None | $275.42 | $338.84 | $645.65 |
Providence Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $338.84 | Professional | None | $245.47 | $245.47 | $338.84 |
United Setting Facility Modifier None Typical Low $354.81 Median $407.38 Typical High $616.60 | Facility | None | $354.81 | $407.38 | $616.60 |
United Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $380.19 | Professional | None | $204.17 | $295.12 | $380.19 |
Wellpoint Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $138.04 Median $147.91 Typical High $173.78 | Professional | 52 · Reduced service | $138.04 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $58.88 Typical High $69.18 | Professional | 53 · Discontinued | $56.23 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $44.67 Typical High $52.48 | Professional | 55 · Aftercare only | $41.69 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $29.51 Typical High $34.67 | Professional | 56 · Pre-op care only | $28.18 | $29.51 | $34.67 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $147.91 Typical High $173.78 | Professional | 52 · Reduced service | $138.04 | $147.91 | $173.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $58.88 Typical High $69.18 | Professional | 53 · Discontinued | $56.23 | $58.88 | $69.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $44.67 Typical High $52.48 | Professional | 55 · Aftercare only | $41.69 | $44.67 | $52.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $29.51 Typical High $34.67 | Professional | 56 · Pre-op care only | $28.18 | $29.51 | $34.67 |
Where Texas sits
The same service costs 4.2 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· 32nd of 51
$324
HI $1,023DE $245
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.