How much rates vary
Facilitymedian $389 · 10th to 90th $282 to $708Professionalmedian $389 · 10th to 90th $282 to $4,786
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 $302.00 Median $302.00 Typical High $331.13 | Facility | None | $302.00 | $302.00 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $602.56 | Professional | None | $302.00 | $302.00 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
BCBS Texas Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $416.87 | Professional | None | $331.13 | $331.13 | $416.87 |
Christus Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | None | $281.84 | $281.84 | $389.05 |
Lucent Health Setting Professional Modifier None Typical Low $3,801.89 Median $4,786.30 Typical High $4,786.30 | Professional | None | $3,801.89 | $4,786.30 | $4,786.30 |
Moda Health Setting Facility Modifier None Typical Low $199.53 Median $389.05 Typical High $707.95 | Facility | None | $199.53 | $389.05 | $707.95 |
Moda Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $602.56 | Professional | None | $302.00 | $302.00 | $602.56 |
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 $302.00 Median $389.05 Typical High $707.95 | Facility | None | $302.00 | $389.05 | $707.95 |
Providence Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | None | $281.84 | $281.84 | $389.05 |
United Setting Facility Modifier None Typical Low $281.84 Median $331.13 Typical High $724.44 | Facility | None | $281.84 | $331.13 | $724.44 |
United Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $467.74 | Professional | None | $257.04 | $389.05 | $467.74 |
Wellpoint Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
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 $151.36 Median $151.36 Typical High $302.00 | Professional | 52 · Reduced service | $151.36 | $151.36 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $123.03 | Professional | 53 · Discontinued | $60.26 | $60.26 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $91.20 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $60.26 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $60.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $151.36 Typical High $302.00 | Professional | 52 · Reduced service | $151.36 | $151.36 | $302.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $123.03 | Professional | 53 · Discontinued | $60.26 | $60.26 | $123.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $91.20 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $91.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $60.26 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $60.26 |
Where Texas sits
The same service costs 2.6 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· 37th of 51
$389
HI $724DE $282
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.