How much rates vary
Facilitymedian $209 · 10th to 90th $155 to $389Professionalmedian $191 · 10th to 90th $155 to $2,818
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 $169.82 Median $169.82 Typical High $177.83 | Facility | None | $169.82 | $169.82 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $177.83 Typical High $309.03 | Professional | None | $169.82 | $177.83 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $389.05 | Professional | None | $194.98 | $288.40 | $389.05 |
BCBS Texas Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $229.09 | Professional | None | $181.97 | $181.97 | $229.09 |
Baylor Scott & White Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $389.05 | Professional | None | $288.40 | $288.40 | $389.05 |
Christus Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $208.93 | Professional | None | $154.88 | $154.88 | $208.93 |
Lucent Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,818.38 Typical High $2,818.38 | Professional | None | $1,949.84 | $2,818.38 | $2,818.38 |
Moda Health Setting Facility Modifier None Typical Low $109.65 Median $204.17 Typical High $389.05 | Facility | None | $109.65 | $204.17 | $389.05 |
Moda Health Setting Professional Modifier None Typical Low $169.82 Median $177.83 Typical High $309.03 | Professional | None | $169.82 | $177.83 | $309.03 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $190.55 Typical High $190.55 | Professional | None | $81.28 | $190.55 | $190.55 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $208.93 Typical High $389.05 | Facility | None | $162.18 | $208.93 | $389.05 |
Providence Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $208.93 | Professional | None | $154.88 | $154.88 | $208.93 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $457.09 | Facility | None | $389.05 | $389.05 | $457.09 |
United Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $239.88 | Professional | None | $128.82 | $186.21 | $239.88 |
Wellpoint Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
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 $83.18 Median $89.13 Typical High $109.65 | Professional | 52 · Reduced service | $83.18 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $35.48 Typical High $43.65 | Professional | 53 · Discontinued | $33.11 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $26.30 Typical High $33.11 | Professional | 55 · Aftercare only | $25.12 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $17.78 Typical High $21.88 | Professional | 56 · Pre-op care only | $16.60 | $17.78 | $21.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $89.13 Typical High $104.71 | Professional | 52 · Reduced service | $83.18 | $89.13 | $104.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $35.48 Typical High $42.66 | Professional | 53 · Discontinued | $33.11 | $35.48 | $42.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $26.30 Typical High $31.62 | Professional | 55 · Aftercare only | $25.12 | $26.30 | $31.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $17.78 Typical High $21.38 | Professional | 56 · Pre-op care only | $16.60 | $17.78 | $21.38 |
Where Texas sits
The same service costs 2.4 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· 40th of 51
$195
HI $380DE $158
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.