How much rates vary
Facilitymedian $447 · 10th to 90th $363 to $851Professionalmedian $447 · 10th to 90th $331 to $7,413
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 $371.54 Median $371.54 Typical High $389.05 | Facility | None | $371.54 | $371.54 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $467.74 | Professional | None | $363.08 | $389.05 | $467.74 |
BCBS Texas Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $501.19 | Professional | None | $398.11 | $398.11 | $501.19 |
Christus 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 Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $446.68 | Professional | None | $331.13 | $331.13 | $446.68 |
Lucent Health Setting Professional Modifier None Typical Low $6,309.57 Median $7,413.10 Typical High $7,413.10 | Professional | None | $6,309.57 | $7,413.10 | $7,413.10 |
Moda Health Setting Facility Modifier None Typical Low $234.42 Median $467.74 Typical High $851.14 | Facility | None | $234.42 | $467.74 | $851.14 |
Moda Health Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $575.44 | Professional | None | $363.08 | $389.05 | $575.44 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $478.63 Typical High $478.63 | Professional | None | $81.28 | $478.63 | $478.63 |
Providence Setting Facility Modifier None Typical Low $363.08 Median $446.68 Typical High $851.14 | Facility | None | $363.08 | $446.68 | $851.14 |
Providence Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $446.68 | Professional | None | $331.13 | $331.13 | $446.68 |
United Setting Facility Modifier None Typical Low $478.63 Median $630.96 Typical High $831.76 | Facility | None | $478.63 | $630.96 | $831.76 |
United Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $512.86 | Professional | None | $275.42 | $398.11 | $512.86 |
Wellpoint Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
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 $181.97 Median $194.98 Typical High $239.88 | Professional | 52 · Reduced service | $181.97 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $77.62 Typical High $95.50 | Professional | 53 · Discontinued | $72.44 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $58.88 Typical High $72.44 | Professional | 55 · Aftercare only | $54.95 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $38.90 Typical High $47.86 | Professional | 56 · Pre-op care only | $36.31 | $38.90 | $47.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $194.98 Typical High $223.87 | Professional | 52 · Reduced service | $181.97 | $194.98 | $223.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $77.62 Typical High $91.20 | Professional | 53 · Discontinued | $72.44 | $77.62 | $91.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $58.88 Typical High $67.61 | Professional | 55 · Aftercare only | $54.95 | $58.88 | $67.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $38.90 Typical High $45.71 | Professional | 56 · Pre-op care only | $36.31 | $38.90 | $45.71 |
Where Texas sits
The same service costs 4.6 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· 36th of 51
$447
HI $1,514DE $331
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.