How much rates vary
Facilitymedian $617 · 10th to 90th $617 to $1,122Professionalmedian $617 · 10th to 90th $447 to $8,318
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 $501.19 Median $501.19 Typical High $512.86 | Facility | None | $501.19 | $501.19 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $645.65 | Professional | None | $489.78 | $512.86 | $645.65 |
BCBS Texas Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $660.69 | Professional | None | $524.81 | $524.81 | $660.69 |
Christus Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $616.60 | Professional | None | $446.68 | $446.68 | $616.60 |
Lucent Health Setting Professional Modifier None Typical Low $5,623.41 Median $8,317.64 Typical High $8,317.64 | Professional | None | $5,623.41 | $8,317.64 | $8,317.64 |
Moda Health Setting Facility Modifier None Typical Low $512.86 Median $912.01 Typical High $1,122.02 | Facility | None | $512.86 | $912.01 | $1,122.02 |
Moda Health Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $724.44 | Professional | None | $489.78 | $512.86 | $724.44 |
Providence Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $1,122.02 | Facility | None | $616.60 | $616.60 | $1,122.02 |
Providence Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $616.60 | Professional | None | $446.68 | $446.68 | $616.60 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,348.96 | Facility | None | $1,148.15 | $1,148.15 | $1,348.96 |
United Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $776.25 | Professional | None | $389.05 | $549.54 | $776.25 |
Wellpoint Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
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 $245.47 Median $257.04 Typical High $316.23 | Professional | 52 · Reduced service | $245.47 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $102.33 Typical High $125.89 | Professional | 53 · Discontinued | $97.72 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $95.50 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $63.10 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $63.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $257.04 Typical High $316.23 | Professional | 52 · Reduced service | $245.47 | $257.04 | $316.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $102.33 Typical High $125.89 | Professional | 53 · Discontinued | $97.72 | $102.33 | $125.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $93.33 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $93.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $63.10 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $63.10 |
Where Texas sits
The same service costs 2.6 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· 35th of 51
$617
HI $1,175DE $447
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.