How much rates vary
Facilitymedian $245 · 10th to 90th $178 to $427Professionalmedian $224 · 10th to 90th $178 to $2,692
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 $186.21 Median $186.21 Typical High $190.55 | Facility | None | $186.21 | $186.21 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $190.55 Typical High $229.09 | Professional | None | $181.97 | $190.55 | $229.09 |
BCBS Texas Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Christus Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Lucent Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,344.23 | $2,691.53 | $2,691.53 |
Moda Health Setting Facility Modifier None Typical Low $114.82 Median $234.42 Typical High $426.58 | Facility | None | $114.82 | $234.42 | $426.58 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $190.55 Typical High $257.04 | Professional | None | $181.97 | $190.55 | $257.04 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $245.47 Typical High $245.47 | Professional | None | $81.28 | $245.47 | $245.47 |
Providence Setting Facility Modifier None Typical Low $177.83 Median $245.47 Typical High $426.58 | Facility | None | $177.83 | $245.47 | $426.58 |
Providence Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
United Setting Facility Modifier None Typical Low $199.53 Median $234.42 Typical High $407.38 | Facility | None | $199.53 | $234.42 | $407.38 |
United Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $257.04 | Professional | None | $138.04 | $194.98 | $257.04 |
Wellpoint Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $91.20 Median $95.50 Typical High $114.82 | Professional | 52 · Reduced service | $91.20 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $38.90 Typical High $45.71 | Professional | 53 · Discontinued | $36.31 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.84 Typical High $34.67 | Professional | 55 · Aftercare only | $26.92 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.05 Typical High $22.91 | Professional | 56 · Pre-op care only | $18.20 | $19.05 | $22.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $95.50 Typical High $114.82 | Professional | 52 · Reduced service | $91.20 | $95.50 | $114.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $38.90 Typical High $45.71 | Professional | 53 · Discontinued | $36.31 | $38.90 | $45.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.84 Typical High $34.67 | Professional | 55 · Aftercare only | $26.92 | $28.84 | $34.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.05 Typical High $22.91 | Professional | 56 · Pre-op care only | $18.20 | $19.05 | $22.91 |
Where Texas sits
The same service costs 3.2 times more in Hawaii than in Alabama. 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· 29th of 51
$224
HI $562AL $178
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.