How much rates vary
Facilitymedian $490 · 10th to 90th $339 to $813Professionalmedian $417 · 10th to 90th $355 to $6,026
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 $354.81 Median $354.81 Typical High $363.08 | Facility | None | $354.81 | $354.81 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $363.08 Typical High $467.74 | Professional | None | $346.74 | $363.08 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
BCBS Texas Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Christus Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $489.78 | Professional | None | $363.08 | $363.08 | $489.78 |
Lucent Health Setting Professional Modifier None Typical Low $5,128.61 Median $6,025.60 Typical High $6,025.60 | Professional | None | $5,128.61 | $6,025.60 | $6,025.60 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $446.68 Typical High $812.83 | Facility | None | $257.04 | $446.68 | $812.83 |
Moda Health Setting Professional Modifier None Typical Low $346.74 Median $363.08 Typical High $645.65 | Professional | None | $346.74 | $363.08 | $645.65 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $416.87 Typical High $416.87 | Professional | None | $81.28 | $416.87 | $416.87 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $489.78 Typical High $812.83 | Facility | None | $338.84 | $489.78 | $812.83 |
Providence Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $489.78 | Professional | None | $363.08 | $363.08 | $489.78 |
United Setting Facility Modifier None Typical Low $478.63 Median $524.81 Typical High $912.01 | Facility | None | $478.63 | $524.81 | $912.01 |
United Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $562.34 | Professional | None | $302.00 | $426.58 | $562.34 |
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 $173.78 Median $181.97 Typical High $234.42 | Professional | 52 · Reduced service | $173.78 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $74.13 Typical High $93.33 | Professional | 53 · Discontinued | $69.18 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $54.95 Typical High $69.18 | Professional | 55 · Aftercare only | $52.48 | $54.95 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $36.31 Typical High $46.77 | Professional | 56 · Pre-op care only | $34.67 | $36.31 | $46.77 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $181.97 Typical High $229.09 | Professional | 52 · Reduced service | $173.78 | $181.97 | $229.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $74.13 Typical High $91.20 | Professional | 53 · Discontinued | $69.18 | $74.13 | $91.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $54.95 Typical High $69.18 | Professional | 55 · Aftercare only | $52.48 | $54.95 | $69.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $36.31 Typical High $45.71 | Professional | 56 · Pre-op care only | $34.67 | $36.31 | $45.71 |
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· 46th of 51
$427
HI $1,175DE $363
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.