How much rates vary
Facilitymedian $1,175 · 10th to 90th $741 to $2,042Professionalmedian $1,175 · 10th to 90th $851 to $14,454
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 $870.96 Median $870.96 Typical High $954.99 | Facility | None | $870.96 | $870.96 | $954.99 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,778.28 | Professional | None | $870.96 | $870.96 | $1,778.28 |
BCBS Texas Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Christus Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,174.90 | Professional | None | $851.14 | $851.14 | $1,174.90 |
Lucent Health Setting Professional Modifier None Typical Low $12,589.25 Median $14,454.40 Typical High $14,454.40 | Professional | None | $12,589.25 | $14,454.40 | $14,454.40 |
Moda Health Setting Facility Modifier None Typical Low $602.56 Median $1,122.02 Typical High $2,041.74 | Facility | None | $602.56 | $1,122.02 | $2,041.74 |
Moda Health Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,778.28 | Professional | None | $870.96 | $870.96 | $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 $1,174.90 Typical High $2,041.74 | Facility | None | $870.96 | $1,174.90 | $2,041.74 |
Providence Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,174.90 | Professional | None | $851.14 | $851.14 | $1,174.90 |
United Setting Facility Modifier None Typical Low $741.31 Median $933.25 Typical High $2,137.96 | Facility | None | $741.31 | $933.25 | $2,137.96 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,174.90 Typical High $1,412.54 | Professional | None | $776.25 | $1,174.90 | $1,412.54 |
Wellpoint Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
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 $436.52 Median $436.52 Typical High $870.96 | Professional | 52 · Reduced service | $436.52 | $436.52 | $870.96 |
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 $131.83 Median $131.83 Typical High $263.03 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $177.83 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $177.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $436.52 Typical High $870.96 | Professional | 52 · Reduced service | $436.52 | $436.52 | $870.96 |
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 $131.83 Median $131.83 Typical High $263.03 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $263.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $177.83 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $177.83 |
Where Texas sits
The same service costs 3.0 times more in Montana 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
$1,175
MT $2,512DE $851
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.