How much rates vary
Facilitymedian $851 · 10th to 90th $575 to $1,380Professionalmedian $794 · 10th to 90th $603 to $13,804
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 $602.56 Median $602.56 Typical High $630.96 | Facility | None | $602.56 | $602.56 | $630.96 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $794.33 | Professional | None | $588.84 | $630.96 | $794.33 |
BCBS Texas Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $794.33 | Professional | None | $645.65 | $645.65 | $794.33 |
Christus Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $851.14 | Professional | None | $616.60 | $616.60 | $851.14 |
Lucent Health Setting Professional Modifier None Typical Low $8,709.64 Median $13,803.84 Typical High $13,803.84 | Professional | None | $8,709.64 | $13,803.84 | $13,803.84 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $758.58 Typical High $1,380.38 | Facility | None | $436.52 | $758.58 | $1,380.38 |
Moda Health Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $912.01 | Professional | None | $588.84 | $630.96 | $912.01 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $812.83 Typical High $812.83 | Professional | None | $81.28 | $812.83 | $812.83 |
Providence Setting Facility Modifier None Typical Low $575.44 Median $851.14 Typical High $1,380.38 | Facility | None | $575.44 | $851.14 | $1,380.38 |
Providence Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $851.14 | Professional | None | $616.60 | $616.60 | $851.14 |
United Setting Facility Modifier None Typical Low $630.96 Median $776.25 Typical High $1,548.82 | Facility | None | $630.96 | $776.25 | $1,548.82 |
United Setting Professional Modifier None Typical Low $512.86 Median $741.31 Typical High $954.99 | Professional | None | $512.86 | $741.31 | $954.99 |
Wellpoint Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $812.83 | Professional | None | $794.33 | $794.33 | $812.83 |
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 $295.12 Median $316.23 Typical High $398.11 | Professional | 52 · Reduced service | $295.12 | $316.23 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $125.89 Typical High $158.49 | Professional | 53 · Discontinued | $117.49 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $93.33 Typical High $117.49 | Professional | 55 · Aftercare only | $89.13 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $63.10 Typical High $79.43 | Professional | 56 · Pre-op care only | $58.88 | $63.10 | $79.43 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $316.23 Typical High $389.05 | Professional | 52 · Reduced service | $295.12 | $316.23 | $389.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $125.89 Typical High $154.88 | Professional | 53 · Discontinued | $117.49 | $125.89 | $154.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $93.33 Typical High $117.49 | Professional | 55 · Aftercare only | $89.13 | $93.33 | $117.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $63.10 Typical High $77.62 | Professional | 56 · Pre-op care only | $58.88 | $63.10 | $77.62 |
Where Texas sits
The same service costs 3.0 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· 30th of 51
$813
HI $1,820DE $617
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.