How much rates vary
Facilitymedian $269 · 10th to 90th $155 to $372Professionalmedian $219 · 10th to 90th $158 to $2,692
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 $158.49 Median $158.49 Typical High $169.82 | Facility | None | $158.49 | $158.49 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $316.23 | Professional | None | $158.49 | $158.49 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
BCBS Texas Setting Professional Modifier None Typical Low $173.78 Median $281.84 Typical High $281.84 | Professional | None | $173.78 | $281.84 | $281.84 |
Christus Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
Lucent Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,905.46 | $2,691.53 | $2,691.53 |
Moda Health Setting Facility Modifier None Typical Low $109.65 Median $204.17 Typical High $371.54 | Facility | None | $109.65 | $204.17 | $371.54 |
Moda Health Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $316.23 | Professional | None | $158.49 | $158.49 | $316.23 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $213.80 Typical High $213.80 | Professional | None | $81.28 | $213.80 | $213.80 |
Providence Setting Facility Modifier None Typical Low $154.88 Median $269.15 Typical High $371.54 | Facility | None | $154.88 | $269.15 | $371.54 |
Providence Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
United Setting Facility Modifier None Typical Low $158.49 Median $173.78 Typical High $389.05 | Facility | None | $158.49 | $173.78 | $389.05 |
United Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $251.19 | Professional | None | $141.25 | $213.80 | $251.19 |
Wellpoint Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $79.43 Median $79.43 Typical High $158.49 | Professional | 52 · Reduced service | $79.43 | $79.43 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $63.10 | Professional | 53 · Discontinued | $31.62 | $31.62 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $47.86 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $31.62 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $31.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $79.43 Typical High $158.49 | Professional | 52 · Reduced service | $79.43 | $79.43 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $63.10 | Professional | 53 · Discontinued | $31.62 | $31.62 | $63.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $47.86 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $47.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $31.62 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $31.62 |
Where Texas sits
The same service costs 2.0 times more in Wisconsin than in Colorado. 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
$224
WI $407CO $200
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.