How much rates vary
Facilitymedian $309 · 10th to 90th $204 to $479Professionalmedian $282 · 10th to 90th $209 to $3,236
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 $208.93 Median $208.93 Typical High $223.87 | Facility | None | $208.93 | $208.93 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $416.87 | Professional | None | $208.93 | $208.93 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
BCBS Texas Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Christus Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $309.03 | Professional | None | $223.87 | $223.87 | $309.03 |
Lucent Health Setting Professional Modifier None Typical Low $2,398.83 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,398.83 | $3,235.94 | $3,235.94 |
Moda Health Setting Facility Modifier None Typical Low $128.82 Median $269.15 Typical High $478.63 | Facility | None | $128.82 | $269.15 | $478.63 |
Moda Health Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $416.87 | Professional | None | $208.93 | $208.93 | $416.87 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $281.84 Typical High $281.84 | Professional | None | $81.28 | $281.84 | $281.84 |
Providence Setting Facility Modifier None Typical Low $204.17 Median $309.03 Typical High $478.63 | Facility | None | $204.17 | $309.03 | $478.63 |
Providence Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $309.03 | Professional | None | $223.87 | $223.87 | $309.03 |
United Setting Facility Modifier None Typical Low $218.78 Median $245.47 Typical High $457.09 | Facility | None | $218.78 | $245.47 | $457.09 |
United Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $302.00 | Professional | None | $165.96 | $251.19 | $302.00 |
Wellpoint Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $104.71 Median $104.71 Typical High $208.93 | Professional | 52 · Reduced service | $104.71 | $104.71 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $83.18 | Professional | 53 · Discontinued | $41.69 | $41.69 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $61.66 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $41.69 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $41.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $104.71 Typical High $208.93 | Professional | 52 · Reduced service | $104.71 | $104.71 | $208.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $83.18 | Professional | 53 · Discontinued | $41.69 | $41.69 | $83.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $61.66 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $61.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $41.69 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $41.69 |
Where Texas sits
The same service costs 2.5 times more in Hawaii than in Pennsylvania. 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· 25th of 51
$282
HI $525PA $214
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.