How much rates vary
Facilitymedian $229 · 10th to 90th $151 to $398Professionalmedian $229 · 10th to 90th $166 to $3,548
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 $169.82 Median $169.82 Typical High $186.21 | Facility | None | $169.82 | $169.82 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $346.74 | Professional | None | $169.82 | $169.82 | $346.74 |
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 $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
Lucent Health Setting Professional Modifier None Typical Low $2,290.87 Median $3,548.13 Typical High $3,548.13 | Professional | None | $2,290.87 | $3,548.13 | $3,548.13 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $218.78 Typical High $398.11 | Facility | None | $117.49 | $218.78 | $398.11 |
Moda Health Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $346.74 | Professional | None | $169.82 | $169.82 | $346.74 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $223.87 Typical High $223.87 | Professional | None | $81.28 | $223.87 | $223.87 |
Providence Setting Facility Modifier None Typical Low $169.82 Median $229.09 Typical High $398.11 | Facility | None | $169.82 | $229.09 | $398.11 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
United Setting Facility Modifier None Typical Low $151.36 Median $190.55 Typical High $426.58 | Facility | None | $151.36 | $190.55 | $426.58 |
United Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $275.42 | Professional | None | $151.36 | $229.09 | $275.42 |
Wellpoint Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
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 $85.11 Median $85.11 Typical High $169.82 | Professional | 52 · Reduced service | $85.11 | $85.11 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $69.18 | Professional | 53 · Discontinued | $34.67 | $34.67 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $51.29 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $34.67 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $34.67 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $85.11 Typical High $169.82 | Professional | 52 · Reduced service | $85.11 | $85.11 | $169.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $69.18 | Professional | 53 · Discontinued | $34.67 | $34.67 | $69.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $51.29 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $51.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $34.67 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $34.67 |
Where Texas sits
The same service costs 2.7 times more in Montana 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· 31st of 51
$229
MT $457DE $170
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.