How much rates vary
Facilitymedian $490 · 10th to 90th $209 to $891Professionalmedian $468 · 10th to 90th $355 to $5,012
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 $380.19 Median $380.19 Typical High $416.87 | Facility | None | $380.19 | $380.19 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $758.58 | Professional | None | $380.19 | $380.19 | $758.58 |
BCBS Texas Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Christus Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
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 $354.81 Median $354.81 Typical High $489.78 | Professional | None | $354.81 | $354.81 | $489.78 |
Lucent Health Setting Professional Modifier None Typical Low $4,365.16 Median $5,011.87 Typical High $5,011.87 | Professional | None | $4,365.16 | $5,011.87 | $5,011.87 |
Moda Health Setting Facility Modifier None Typical Low $208.93 Median $489.78 Typical High $891.25 | Facility | None | $208.93 | $489.78 | $891.25 |
Moda Health Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $758.58 | Professional | None | $380.19 | $380.19 | $758.58 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $478.63 Typical High $478.63 | Professional | None | $81.28 | $478.63 | $478.63 |
Providence Setting Facility Modifier None Typical Low $371.54 Median $489.78 Typical High $891.25 | Facility | None | $371.54 | $489.78 | $891.25 |
Providence Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $489.78 | Professional | None | $354.81 | $354.81 | $489.78 |
United Setting Facility Modifier None Typical Low $165.96 Median $323.59 Typical High $758.58 | Facility | None | $165.96 | $323.59 | $758.58 |
United Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $489.78 | Professional | None | $269.15 | $407.38 | $489.78 |
Wellpoint Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
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 $190.55 Median $190.55 Typical High $380.19 | Professional | 52 · Reduced service | $190.55 | $190.55 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $151.36 | Professional | 53 · Discontinued | $75.86 | $75.86 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $114.82 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $75.86 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $75.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $190.55 Typical High $380.19 | Professional | 52 · Reduced service | $190.55 | $190.55 | $380.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $151.36 | Professional | 53 · Discontinued | $75.86 | $75.86 | $151.36 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $114.82 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $114.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $75.86 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $75.86 |
Where Texas sits
The same service costs 2.4 times more in Iowa than in Kansas. 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· 23rd of 51
$479
IA $776KS $324
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.