How much rates vary
Facilitymedian $501 · 10th to 90th $229 to $708Professionalmedian $407 · 10th to 90th $302 to $4,571
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 $302.00 Median $302.00 Typical High $323.59 | Facility | None | $302.00 | $302.00 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $602.56 | Professional | None | $302.00 | $302.00 | $602.56 |
BCBS Texas Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Christus Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Lucent Health Setting Professional Modifier None Typical Low $3,630.78 Median $4,570.88 Typical High $4,570.88 | Professional | None | $3,630.78 | $4,570.88 | $4,570.88 |
Moda Health Setting Facility Modifier None Typical Low $186.21 Median $389.05 Typical High $707.95 | Facility | None | $186.21 | $389.05 | $707.95 |
Moda Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $602.56 | Professional | None | $302.00 | $302.00 | $602.56 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $407.38 Typical High $407.38 | Professional | None | $81.28 | $407.38 | $407.38 |
Providence Setting Facility Modifier None Typical Low $295.12 Median $501.19 Typical High $707.95 | Facility | None | $295.12 | $501.19 | $707.95 |
Providence Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
United Setting Facility Modifier None Typical Low $229.09 Median $288.40 Typical High $676.08 | Facility | None | $229.09 | $288.40 | $676.08 |
United Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $436.52 | Professional | None | $239.88 | $363.08 | $436.52 |
Wellpoint Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
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 $151.36 Median $151.36 Typical High $302.00 | Professional | 52 · Reduced service | $151.36 | $151.36 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $120.23 | Professional | 53 · Discontinued | $60.26 | $60.26 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $91.20 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $60.26 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $60.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $151.36 Typical High $302.00 | Professional | 52 · Reduced service | $151.36 | $151.36 | $302.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $120.23 | Professional | 53 · Discontinued | $60.26 | $60.26 | $120.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $91.20 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $91.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $60.26 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $60.26 |
Where Texas sits
The same service costs 2.3 times more in Wisconsin than in Florida. 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· 27th of 51
$407
WI $776FL $339
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.