How much rates vary
Facilitymedian $513 · 10th to 90th $407 to $955Professionalmedian $501 · 10th to 90th $372 to $7,244
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 $416.87 Median $416.87 Typical High $436.52 | Facility | None | $416.87 | $416.87 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $537.03 | Professional | None | $407.38 | $436.52 | $537.03 |
BCBS Texas Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Christus Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $512.86 | Professional | None | $371.54 | $371.54 | $512.86 |
Lucent Health Setting Professional Modifier None Typical Low $5,370.32 Median $7,244.36 Typical High $7,244.36 | Professional | None | $5,370.32 | $7,244.36 | $7,244.36 |
Moda Health Setting Facility Modifier None Typical Low $263.03 Median $524.81 Typical High $954.99 | Facility | None | $263.03 | $524.81 | $954.99 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $630.96 | Professional | None | $407.38 | $436.52 | $630.96 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $489.78 Typical High $489.78 | Professional | None | $81.28 | $489.78 | $489.78 |
Providence Setting Facility Modifier None Typical Low $407.38 Median $512.86 Typical High $954.99 | Facility | None | $407.38 | $512.86 | $954.99 |
Providence Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $512.86 | Professional | None | $371.54 | $371.54 | $512.86 |
United Setting Facility Modifier None Typical Low $478.63 Median $549.54 Typical High $954.99 | Facility | None | $478.63 | $549.54 | $954.99 |
United Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $588.84 | Professional | None | $316.23 | $457.09 | $588.84 |
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 $204.17 Median $218.78 Typical High $269.15 | Professional | 52 · Reduced service | $204.17 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $87.10 Typical High $109.65 | Professional | 53 · Discontinued | $83.18 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $66.07 Typical High $81.28 | Professional | 55 · Aftercare only | $61.66 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $43.65 Typical High $53.70 | Professional | 56 · Pre-op care only | $40.74 | $43.65 | $53.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $218.78 Typical High $263.03 | Professional | 52 · Reduced service | $204.17 | $218.78 | $263.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $87.10 Typical High $104.71 | Professional | 53 · Discontinued | $83.18 | $87.10 | $104.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $66.07 Typical High $77.62 | Professional | 55 · Aftercare only | $61.66 | $66.07 | $77.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $43.65 Typical High $52.48 | Professional | 56 · Pre-op care only | $40.74 | $43.65 | $52.48 |
Where Texas sits
The same service costs 3.2 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· 31st of 51
$501
HI $1,202DE $372
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.