How much rates vary
Facilitymedian $302 · 10th to 90th $204 to $347Professionalmedian $209 · 10th to 90th $166 to $2,951
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 $181.97 Median $181.97 Typical High $186.21 | Facility | None | $181.97 | $181.97 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $186.21 Typical High $331.13 | Professional | None | $177.83 | $186.21 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $208.93 | Professional | None | $177.83 | $208.93 | $208.93 |
BCBS Texas Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $269.15 | Professional | None | $194.98 | $194.98 | $269.15 |
Christus Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $245.47 | Facility | None | $229.09 | $229.09 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
Lucent Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,454.71 | $2,951.21 | $2,951.21 |
Moda Health Setting Facility Modifier None Typical Low $109.65 Median $229.09 Typical High $416.87 | Facility | None | $109.65 | $229.09 | $416.87 |
Moda Health Setting Professional Modifier None Typical Low $177.83 Median $186.21 Typical High $331.13 | Professional | None | $177.83 | $186.21 | $331.13 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $239.88 Typical High $239.88 | Professional | None | $81.28 | $239.88 | $239.88 |
Providence Setting Facility Modifier None Typical Low $173.78 Median $229.09 Typical High $416.87 | Facility | None | $173.78 | $229.09 | $416.87 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
United Setting Facility Modifier None Typical Low $229.09 Median $251.19 Typical High $398.11 | Facility | None | $229.09 | $251.19 | $398.11 |
United Setting Professional Modifier None Typical Low $131.83 Median $190.55 Typical High $245.47 | Professional | None | $131.83 | $190.55 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
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 $89.13 Median $93.33 Typical High $114.82 | Professional | 52 · Reduced service | $89.13 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.02 Typical High $45.71 | Professional | 53 · Discontinued | $35.48 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.18 Typical High $34.67 | Professional | 55 · Aftercare only | $26.92 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $18.62 Typical High $22.91 | Professional | 56 · Pre-op care only | $17.78 | $18.62 | $22.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $93.33 Typical High $112.20 | Professional | 52 · Reduced service | $89.13 | $93.33 | $112.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.02 Typical High $44.67 | Professional | 53 · Discontinued | $35.48 | $38.02 | $44.67 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.18 Typical High $33.88 | Professional | 55 · Aftercare only | $26.92 | $28.18 | $33.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $18.62 Typical High $22.39 | Professional | 56 · Pre-op care only | $17.78 | $18.62 | $22.39 |
Where Texas sits
The same service costs 3.5 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· 38th of 51
$214
HI $589DE $166
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.