How much rates vary
Facilitymedian $398 · 10th to 90th $275 to $661Professionalmedian $398 · 10th to 90th $282 to $5,248
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 $281.84 Median $281.84 Typical High $302.00 | Facility | None | $281.84 | $281.84 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $562.34 | Professional | None | $281.84 | $281.84 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $489.78 | Professional | None | $380.19 | $489.78 | $489.78 |
BCBS Texas Setting Professional Modifier None Typical Low $309.03 Median $501.19 Typical High $501.19 | Professional | None | $309.03 | $501.19 | $501.19 |
Baylor Scott & White Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $660.69 | Professional | None | $489.78 | $489.78 | $660.69 |
Christus Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Cigna 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 Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $398.11 | Professional | None | $288.40 | $288.40 | $398.11 |
Lucent Health Setting Professional Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $5,248.07 | Professional | None | $3,715.35 | $5,248.07 | $5,248.07 |
Moda Health Setting Facility Modifier None Typical Low $204.17 Median $363.08 Typical High $660.69 | Facility | None | $204.17 | $363.08 | $660.69 |
Moda Health Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $562.34 | Professional | None | $281.84 | $281.84 | $562.34 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $371.54 Typical High $371.54 | Professional | None | $81.28 | $371.54 | $371.54 |
Providence Setting Facility Modifier None Typical Low $275.42 Median $398.11 Typical High $660.69 | Facility | None | $275.42 | $398.11 | $660.69 |
Providence Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $398.11 | Professional | None | $288.40 | $288.40 | $398.11 |
United Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $851.14 | Facility | None | $363.08 | $363.08 | $851.14 |
United Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $478.63 | Professional | None | $263.03 | $398.11 | $478.63 |
Wellpoint Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
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 $141.25 Median $141.25 Typical High $281.84 | Professional | 52 · Reduced service | $141.25 | $141.25 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $112.20 | Professional | 53 · Discontinued | $56.23 | $56.23 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $85.11 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $56.23 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $56.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $141.25 Typical High $281.84 | Professional | 52 · Reduced service | $141.25 | $141.25 | $281.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $112.20 | Professional | 53 · Discontinued | $56.23 | $56.23 | $112.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $85.11 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $85.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $56.23 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $56.23 |
Where Texas sits
The same service costs 2.8 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
$398
HI $794DE $288
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.