How much rates vary
Facilitymedian $363 · 10th to 90th $347 to $603Professionalmedian $372 · 10th to 90th $275 to $6,026
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 |
Ambetter Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
BCBS Texas Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $457.09 | Professional | None | $323.59 | $323.59 | $457.09 |
Baylor Scott & White Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $707.95 | Professional | None | $524.81 | $524.81 | $707.95 |
Christus Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $380.19 | Professional | None | $275.42 | $275.42 | $380.19 |
Lucent Health Setting Professional Modifier None Typical Low $3,981.07 Median $6,025.60 Typical High $6,025.60 | Professional | None | $3,981.07 | $6,025.60 | $6,025.60 |
Moda Health Setting Facility Modifier None Typical Low $190.55 Median $389.05 Typical High $707.95 | Facility | None | $190.55 | $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 $446.68 Typical High $446.68 | Professional | None | $81.28 | $446.68 | $446.68 |
Providence Setting Facility Modifier None Typical Low $295.12 Median $380.19 Typical High $707.95 | Facility | None | $295.12 | $380.19 | $707.95 |
Providence Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $380.19 | Professional | None | $275.42 | $275.42 | $380.19 |
United Setting Facility Modifier None Typical Low $346.74 Median $389.05 Typical High $676.08 | Facility | None | $346.74 | $389.05 | $676.08 |
United Setting Professional Modifier None Typical Low $245.47 Median $363.08 Typical High $436.52 | Professional | None | $245.47 | $363.08 | $436.52 |
Wellpoint Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
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 $44.67 Median $44.67 Typical High $91.20 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $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 $44.67 Median $44.67 Typical High $91.20 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $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 3.2 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· 33rd of 51
$363
HI $871DE $275
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.