How much rates vary
Facilitymedian $407 · 10th to 90th $316 to $759Professionalmedian $407 · 10th to 90th $295 to $5,248
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 $331.13 Median $331.13 Typical High $338.84 | Facility | None | $331.13 | $331.13 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $426.58 | Professional | None | $323.59 | $338.84 | $426.58 |
BCBS Texas Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Christus Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $407.38 | Professional | None | $295.12 | $295.12 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $5,128.61 Median $5,248.07 Typical High $5,248.07 | Professional | None | $5,128.61 | $5,248.07 | $5,248.07 |
Moda Health Setting Facility Modifier None Typical Low $208.93 Median $416.87 Typical High $758.58 | Facility | None | $208.93 | $416.87 | $758.58 |
Moda Health Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $524.81 | Professional | None | $323.59 | $338.84 | $524.81 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $407.38 Typical High $407.38 | Professional | None | $81.28 | $407.38 | $407.38 |
Providence Setting Facility Modifier None Typical Low $316.23 Median $407.38 Typical High $758.58 | Facility | None | $316.23 | $407.38 | $758.58 |
Providence Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $407.38 | Professional | None | $295.12 | $295.12 | $407.38 |
United Setting Facility Modifier None Typical Low $436.52 Median $575.44 Typical High $758.58 | Facility | None | $436.52 | $575.44 | $758.58 |
United Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $467.74 | Professional | None | $251.19 | $363.08 | $467.74 |
Wellpoint Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
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 $162.18 Median $169.82 Typical High $208.93 | Professional | 52 · Reduced service | $162.18 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $67.61 Typical High $85.11 | Professional | 53 · Discontinued | $64.57 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $51.29 Typical High $63.10 | Professional | 55 · Aftercare only | $47.86 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $33.88 Typical High $42.66 | Professional | 56 · Pre-op care only | $32.36 | $33.88 | $42.66 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $169.82 Typical High $204.17 | Professional | 52 · Reduced service | $162.18 | $169.82 | $204.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $67.61 Typical High $81.28 | Professional | 53 · Discontinued | $64.57 | $67.61 | $81.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $51.29 Typical High $61.66 | Professional | 55 · Aftercare only | $47.86 | $51.29 | $61.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $33.88 Typical High $40.74 | Professional | 56 · Pre-op care only | $32.36 | $33.88 | $40.74 |
Where Texas sits
The same service costs 4.3 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· 25th of 51
$407
HI $1,259DE $295
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.