How much rates vary
Facilitymedian $741 · 10th to 90th $661 to $1,585Professionalmedian $741 · 10th to 90th $537 to $11,220
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 $707.95 Median $707.95 Typical High $724.44 | Facility | None | $707.95 | $707.95 | $724.44 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $831.76 | Professional | None | $660.69 | $707.95 | $831.76 |
BCBS Texas Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $933.25 | Professional | None | $741.31 | $741.31 | $933.25 |
Christus Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $741.31 | Professional | None | $537.03 | $537.03 | $741.31 |
Lucent Health Setting Professional Modifier None Typical Low $10,232.93 Median $11,220.18 Typical High $11,220.18 | Professional | None | $10,232.93 | $11,220.18 | $11,220.18 |
Moda Health Setting Facility Modifier None Typical Low $380.19 Median $891.25 Typical High $1,584.89 | Facility | None | $380.19 | $891.25 | $1,584.89 |
Moda Health Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $954.99 | Professional | None | $660.69 | $724.44 | $954.99 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $954.99 Typical High $954.99 | Professional | None | $81.28 | $954.99 | $954.99 |
Providence Setting Facility Modifier None Typical Low $676.08 Median $741.31 Typical High $1,584.89 | Facility | None | $676.08 | $741.31 | $1,584.89 |
Providence Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $741.31 | Professional | None | $537.03 | $537.03 | $741.31 |
United Setting Facility Modifier None Typical Low $776.25 Median $912.01 Typical High $1,348.96 | Facility | None | $776.25 | $912.01 | $1,348.96 |
United Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $851.14 | Professional | None | $457.09 | $645.65 | $851.14 |
Wellpoint Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
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 $338.84 Median $354.81 Typical High $416.87 | Professional | 52 · Reduced service | $338.84 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $144.54 Typical High $165.96 | Professional | 53 · Discontinued | $134.90 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $125.89 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $70.79 Typical High $83.18 | Professional | 56 · Pre-op care only | $67.61 | $70.79 | $83.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $354.81 Typical High $407.38 | Professional | 52 · Reduced service | $331.13 | $354.81 | $407.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $162.18 | Professional | 53 · Discontinued | $131.83 | $144.54 | $162.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $123.03 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $123.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $81.28 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $81.28 |
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· 32nd of 51
$741
HI $2,455DE $537
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.