How much rates vary
Facilitymedian $501 · 10th to 90th $380 to $912Professionalmedian $479 · 10th to 90th $363 to $7,413
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 $398.11 Median $398.11 Typical High $407.38 | Facility | None | $398.11 | $398.11 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $537.03 | Professional | None | $398.11 | $407.38 | $537.03 |
BCBS Texas Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $524.81 | Professional | None | $416.87 | $416.87 | $524.81 |
Christus Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Lucent Health Setting Professional Modifier None Typical Low $5,754.40 Median $7,413.10 Typical High $7,413.10 | Professional | None | $5,754.40 | $7,413.10 | $7,413.10 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $501.19 Typical High $912.01 | Facility | None | $257.04 | $501.19 | $912.01 |
Moda Health Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $724.44 | Professional | None | $398.11 | $407.38 | $724.44 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $478.63 Typical High $478.63 | Professional | None | $81.28 | $478.63 | $478.63 |
Providence Setting Facility Modifier None Typical Low $380.19 Median $501.19 Typical High $912.01 | Facility | None | $380.19 | $501.19 | $912.01 |
Providence Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
United Setting Facility Modifier None Typical Low $537.03 Median $562.34 Typical High $933.25 | Facility | None | $537.03 | $562.34 | $933.25 |
United Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $575.44 | Professional | None | $309.03 | $446.68 | $575.44 |
Wellpoint Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
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 $194.98 Median $204.17 Typical High $257.04 | Professional | 52 · Reduced service | $194.98 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $81.28 Typical High $102.33 | Professional | 53 · Discontinued | $77.62 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $61.66 Typical High $75.86 | Professional | 55 · Aftercare only | $57.54 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $51.29 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $51.29 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $204.17 Typical High $245.47 | Professional | 52 · Reduced service | $194.98 | $204.17 | $245.47 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $81.28 Typical High $97.72 | Professional | 53 · Discontinued | $77.62 | $81.28 | $97.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $61.66 Typical High $74.13 | Professional | 55 · Aftercare only | $57.54 | $61.66 | $74.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $48.98 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $48.98 |
Where Texas sits
The same service costs 3.9 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· 33rd of 51
$490
HI $1,413DE $363
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.