How much rates vary
Facilitymedian $1,230 · 10th to 90th $832 to $1,995Professionalmedian $1,230 · 10th to 90th $851 to $14,791
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 $851.14 Median $851.14 Typical High $912.01 | Facility | None | $851.14 | $851.14 | $912.01 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,698.24 | Professional | None | $851.14 | $851.14 | $1,698.24 |
Ambetter Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
BCBS Texas Setting Professional Modifier None Typical Low $912.01 Median $1,348.96 Typical High $1,348.96 | Professional | None | $912.01 | $1,348.96 | $1,348.96 |
Christus Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,230.27 | Professional | None | $891.25 | $891.25 | $1,230.27 |
Lucent Health Setting Professional Modifier None Typical Low $13,182.57 Median $14,791.08 Typical High $14,791.08 | Professional | None | $13,182.57 | $14,791.08 | $14,791.08 |
Moda Health Setting Facility Modifier None Typical Low $616.60 Median $1,096.48 Typical High $1,995.26 | Facility | None | $616.60 | $1,096.48 | $1,995.26 |
Moda Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,698.24 | Professional | None | $851.14 | $851.14 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $1,047.13 Typical High $1,047.13 | Professional | None | $81.28 | $1,047.13 | $1,047.13 |
Providence Setting Facility Modifier None Typical Low $831.76 Median $1,230.27 Typical High $1,995.26 | Facility | None | $831.76 | $1,230.27 | $1,995.26 |
Providence Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,230.27 | Professional | None | $891.25 | $891.25 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $2,238.72 | Facility | None | $1,071.52 | $1,202.26 | $2,238.72 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,202.26 Typical High $1,445.44 | Professional | None | $812.83 | $1,202.26 | $1,445.44 |
Wellpoint Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
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 $426.58 Median $426.58 Typical High $851.14 | Professional | 52 · Reduced service | $426.58 | $426.58 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $338.84 | Professional | 53 · Discontinued | $169.82 | $169.82 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $251.19 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $169.82 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $169.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $426.58 Typical High $851.14 | Professional | 52 · Reduced service | $426.58 | $426.58 | $851.14 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $338.84 | Professional | 53 · Discontinued | $169.82 | $169.82 | $338.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $251.19 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $251.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $85.11 Typical High $169.82 | Professional | 56 · Pre-op care only | $85.11 | $85.11 | $169.82 |
Where Texas sits
The same service costs 3.1 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· 31st of 51
$1,230
HI $2,754DE $891
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.