How much rates vary
Facilitymedian $263 · 10th to 90th $195 to $468Professionalmedian $245 · 10th to 90th $195 to $4,169
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 $204.17 Median $204.17 Typical High $213.80 | Facility | None | $204.17 | $204.17 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $213.80 Typical High $371.54 | Professional | None | $204.17 | $213.80 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $234.42 | Professional | None | $199.53 | $234.42 | $234.42 |
BCBS Texas Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $275.42 | Professional | None | $218.78 | $218.78 | $275.42 |
Christus Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $263.03 | Professional | None | $194.98 | $194.98 | $263.03 |
Lucent Health Setting Professional Modifier None Typical Low $3,801.89 Median $4,168.69 Typical High $4,168.69 | Professional | None | $3,801.89 | $4,168.69 | $4,168.69 |
Moda Health Setting Facility Modifier None Typical Low $131.83 Median $257.04 Typical High $467.74 | Facility | None | $131.83 | $257.04 | $467.74 |
Moda Health Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $371.54 | Professional | None | $199.53 | $213.80 | $371.54 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $245.47 Typical High $245.47 | Professional | None | $81.28 | $245.47 | $245.47 |
Providence Setting Facility Modifier None Typical Low $194.98 Median $263.03 Typical High $467.74 | Facility | None | $194.98 | $263.03 | $467.74 |
Providence Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $263.03 | Professional | None | $194.98 | $194.98 | $263.03 |
United Setting Facility Modifier None Typical Low $213.80 Median $275.42 Typical High $478.63 | Facility | None | $213.80 | $275.42 | $478.63 |
United Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $295.12 | Professional | None | $158.49 | $229.09 | $295.12 |
Wellpoint Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
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 $100.00 Median $107.15 Typical High $131.83 | Professional | 52 · Reduced service | $100.00 | $107.15 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $42.66 Typical High $52.48 | Professional | 53 · Discontinued | $39.81 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $31.62 Typical High $39.81 | Professional | 55 · Aftercare only | $30.20 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $21.38 Typical High $26.30 | Professional | 56 · Pre-op care only | $19.95 | $21.38 | $26.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $107.15 Typical High $125.89 | Professional | 52 · Reduced service | $100.00 | $107.15 | $125.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $42.66 Typical High $51.29 | Professional | 53 · Discontinued | $39.81 | $42.66 | $51.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $31.62 Typical High $38.02 | Professional | 55 · Aftercare only | $30.20 | $31.62 | $38.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $21.38 Typical High $25.70 | Professional | 56 · Pre-op care only | $19.95 | $21.38 | $25.70 |
Where Texas sits
The same service costs 4.7 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
$251
HI $912DE $195
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.