How much rates vary
Facilitymedian $1,380 · 10th to 90th $871 to $2,089Professionalmedian $1,096 · 10th to 90th $891 to $13,490
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 $891.25 Median $891.25 Typical High $977.24 | Facility | None | $891.25 | $891.25 | $977.24 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,778.28 | Professional | None | $891.25 | $891.25 | $1,778.28 |
BCBS Texas Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Christus Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,000.00 | $1,380.38 |
Lucent Health Setting Professional Modifier None Typical Low $10,232.93 Median $13,489.63 Typical High $13,489.63 | Professional | None | $10,232.93 | $13,489.63 | $13,489.63 |
Moda Health Setting Facility Modifier None Typical Low $562.34 Median $1,148.15 Typical High $2,089.30 | Facility | None | $562.34 | $1,148.15 | $2,089.30 |
Moda Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,778.28 | Professional | None | $891.25 | $891.25 | $1,778.28 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $1,023.29 Typical High $1,023.29 | Professional | None | $81.28 | $1,023.29 | $1,023.29 |
Providence Setting Facility Modifier None Typical Low $870.96 Median $1,380.38 Typical High $2,089.30 | Facility | None | $870.96 | $1,380.38 | $2,089.30 |
Providence Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,380.38 | Professional | None | $1,000.00 | $1,000.00 | $1,380.38 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,047.13 Typical High $2,041.74 | Facility | None | $933.25 | $1,047.13 | $2,041.74 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $1,318.26 | Professional | None | $724.44 | $1,096.48 | $1,318.26 |
Wellpoint Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
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 $446.68 Median $446.68 Typical High $891.25 | Professional | 52 · Reduced service | $446.68 | $446.68 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $354.81 | Professional | 53 · Discontinued | $177.83 | $177.83 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $269.15 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $177.83 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $177.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $446.68 Typical High $891.25 | Professional | 52 · Reduced service | $446.68 | $446.68 | $891.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $354.81 | Professional | 53 · Discontinued | $177.83 | $177.83 | $354.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $269.15 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $269.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $177.83 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $177.83 |
Where Texas sits
The same service costs 2.5 times more in Hawaii than in Washington, DC. 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· 30th of 51
$1,096
HI $2,291DC $933
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.