How much rates vary
Facilitymedian $891 · 10th to 90th $589 to $1,413Professionalmedian $851 · 10th to 90th $617 to $12,023
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 $616.60 Median $616.60 Typical High $630.96 | Facility | None | $616.60 | $616.60 | $630.96 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $812.83 | Professional | None | $602.56 | $630.96 | $812.83 |
BCBS Texas Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Christus Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $891.25 | Professional | None | $645.65 | $645.65 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $8,317.64 Median $12,022.64 Typical High $12,022.64 | Professional | None | $8,317.64 | $12,022.64 | $12,022.64 |
Moda Health Setting Facility Modifier None Typical Low $446.68 Median $776.25 Typical High $1,412.54 | Facility | None | $446.68 | $776.25 | $1,412.54 |
Moda Health Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $977.24 | Professional | None | $602.56 | $630.96 | $977.24 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $758.58 Typical High $758.58 | Professional | None | $81.28 | $758.58 | $758.58 |
Providence Setting Facility Modifier None Typical Low $588.84 Median $891.25 Typical High $1,412.54 | Facility | None | $588.84 | $891.25 | $1,412.54 |
Providence Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $891.25 | Professional | None | $645.65 | $645.65 | $891.25 |
United Setting Facility Modifier None Typical Low $851.14 Median $870.96 Typical High $1,584.89 | Facility | None | $851.14 | $870.96 | $1,584.89 |
United Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $977.24 | Professional | None | $524.81 | $758.58 | $977.24 |
Wellpoint Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
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 $302.00 Median $316.23 Typical High $407.38 | Professional | 52 · Reduced service | $302.00 | $316.23 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $128.82 Typical High $162.18 | Professional | 53 · Discontinued | $120.23 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $95.50 Typical High $120.23 | Professional | 55 · Aftercare only | $91.20 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $63.10 Typical High $81.28 | Professional | 56 · Pre-op care only | $60.26 | $63.10 | $81.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $316.23 Typical High $407.38 | Professional | 52 · Reduced service | $302.00 | $316.23 | $407.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $128.82 Typical High $162.18 | Professional | 53 · Discontinued | $120.23 | $128.82 | $162.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $95.50 Typical High $120.23 | Professional | 55 · Aftercare only | $91.20 | $95.50 | $120.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $63.10 Typical High $81.28 | Professional | 56 · Pre-op care only | $60.26 | $63.10 | $81.28 |
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· 33rd of 51
$851
HI $1,905DE $646
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.