How much rates vary
Facilitymedian $204 · 10th to 90th $178 to $447Professionalmedian $214 · 10th to 90th $148 to $2,570
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 $190.55 Median $190.55 Typical High $204.17 | Facility | None | $190.55 | $190.55 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $380.19 | Professional | None | $190.55 | $190.55 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $331.13 | Professional | None | $309.03 | $331.13 | $331.13 |
BCBS Texas Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $257.04 | Professional | None | $208.93 | $257.04 | $257.04 |
Christus Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $204.17 | Professional | None | $147.91 | $147.91 | $204.17 |
Lucent Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,187.76 | $2,570.40 | $2,570.40 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $245.47 Typical High $446.68 | Facility | None | $104.71 | $245.47 | $446.68 |
Moda Health Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $380.19 | Professional | None | $190.55 | $190.55 | $380.19 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $251.19 Typical High $251.19 | Professional | None | $81.28 | $251.19 | $251.19 |
Providence Setting Facility Modifier None Typical Low $186.21 Median $204.17 Typical High $446.68 | Facility | None | $186.21 | $204.17 | $446.68 |
Providence Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $204.17 | Professional | None | $147.91 | $147.91 | $204.17 |
United Setting Facility Modifier None Typical Low $181.97 Median $218.78 Typical High $380.19 | Facility | None | $181.97 | $218.78 | $380.19 |
United Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $245.47 | Professional | None | $134.90 | $204.17 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
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 $95.50 Median $95.50 Typical High $190.55 | Professional | 52 · Reduced service | $95.50 | $95.50 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $75.86 | Professional | 53 · Discontinued | $38.02 | $38.02 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $57.54 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $38.02 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $38.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $95.50 Typical High $190.55 | Professional | 52 · Reduced service | $95.50 | $95.50 | $190.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $75.86 | Professional | 53 · Discontinued | $38.02 | $38.02 | $75.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $57.54 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $57.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $38.02 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $38.02 |
Where Texas sits
The same service costs 3.3 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· 29th of 51
$214
HI $501DE $151
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.