How much rates vary
Facilitymedian $589 · 10th to 90th $257 to $955Professionalmedian $537 · 10th to 90th $407 to $6,761
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 $407.38 Median $407.38 Typical High $436.52 | Facility | None | $407.38 | $407.38 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $812.83 | Professional | None | $407.38 | $407.38 | $812.83 |
BCBS Texas Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Christus Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $588.84 | Professional | None | $426.58 | $426.58 | $588.84 |
Lucent Health Setting Professional Modifier None Typical Low $5,370.32 Median $6,760.83 Typical High $6,760.83 | Professional | None | $5,370.32 | $6,760.83 | $6,760.83 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $524.81 Typical High $954.99 | Facility | None | $257.04 | $524.81 | $954.99 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $812.83 | Professional | None | $407.38 | $407.38 | $812.83 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $588.84 Typical High $588.84 | Professional | None | $81.28 | $588.84 | $588.84 |
Providence Setting Facility Modifier None Typical Low $398.11 Median $588.84 Typical High $954.99 | Facility | None | $398.11 | $588.84 | $954.99 |
Providence Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $588.84 | Professional | None | $426.58 | $426.58 | $588.84 |
United Setting Facility Modifier None Typical Low $181.97 Median $398.11 Typical High $912.01 | Facility | None | $181.97 | $398.11 | $912.01 |
United Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $588.84 | Professional | None | $331.13 | $489.78 | $588.84 |
Wellpoint Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
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 $204.17 Median $204.17 Typical High $407.38 | Professional | 52 · Reduced service | $204.17 | $204.17 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $162.18 | Professional | 53 · Discontinued | $81.28 | $81.28 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $123.03 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $81.28 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $81.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $204.17 Typical High $407.38 | Professional | 52 · Reduced service | $204.17 | $204.17 | $407.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $162.18 | Professional | 53 · Discontinued | $81.28 | $81.28 | $162.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $123.03 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $123.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $81.28 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $81.28 |
Where Texas sits
The same service costs 2.5 times more in Montana than in Alabama. 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· 24th of 51
$550
MT $1,072AL $427
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.