How much rates vary
Facilitymedian $269 · 10th to 90th $240 to $575Professionalmedian $295 · 10th to 90th $200 to $3,311
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 $245.47 Median $245.47 Typical High $269.15 | Facility | None | $245.47 | $245.47 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $501.19 | Professional | None | $245.47 | $245.47 | $501.19 |
BCBS Texas Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Christus Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
Lucent Health Setting Professional Modifier None Typical Low $2,884.03 Median $3,311.31 Typical High $3,311.31 | Professional | None | $2,884.03 | $3,311.31 | $3,311.31 |
Moda Health Setting Facility Modifier None Typical Low $141.25 Median $316.23 Typical High $575.44 | Facility | None | $141.25 | $316.23 | $575.44 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $501.19 | Professional | None | $245.47 | $245.47 | $501.19 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $331.13 Typical High $331.13 | Professional | None | $81.28 | $331.13 | $331.13 |
Providence Setting Facility Modifier None Typical Low $245.47 Median $269.15 Typical High $575.44 | Facility | None | $245.47 | $269.15 | $575.44 |
Providence Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
United Setting Facility Modifier None Typical Low $281.84 Median $288.40 Typical High $501.19 | Facility | None | $281.84 | $288.40 | $501.19 |
United Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $323.59 | Professional | None | $181.97 | $275.42 | $323.59 |
Wellpoint Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
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 $123.03 Median $123.03 Typical High $245.47 | Professional | 52 · Reduced service | $123.03 | $123.03 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $100.00 | Professional | 53 · Discontinued | $50.12 | $50.12 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $74.13 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $50.12 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $50.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $123.03 Typical High $245.47 | Professional | 52 · Reduced service | $123.03 | $123.03 | $245.47 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $100.00 | Professional | 53 · Discontinued | $50.12 | $50.12 | $100.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $37.15 Typical High $74.13 | Professional | 55 · Aftercare only | $37.15 | $37.15 | $74.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $50.12 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $50.12 |
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· 27th of 51
$288
HI $661DE $200
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.