How much rates vary
Facilitymedian $447 · 10th to 90th $324 to $776Professionalmedian $468 · 10th to 90th $331 to $5,370
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 $331.13 Median $331.13 Typical High $363.08 | Facility | None | $331.13 | $331.13 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $660.69 | Professional | None | $331.13 | $331.13 | $660.69 |
Ambetter Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $549.54 | Professional | None | $426.58 | $426.58 | $549.54 |
BCBS Texas Setting Professional Modifier None Typical Low $363.08 Median $588.84 Typical High $588.84 | Professional | None | $363.08 | $588.84 | $588.84 |
Christus Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna 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 Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $446.68 | Professional | None | $331.13 | $331.13 | $446.68 |
Lucent Health Setting Professional Modifier None Typical Low $4,786.30 Median $5,370.32 Typical High $5,370.32 | Professional | None | $4,786.30 | $5,370.32 | $5,370.32 |
Moda Health Setting Facility Modifier None Typical Low $229.09 Median $426.58 Typical High $776.25 | Facility | None | $229.09 | $426.58 | $776.25 |
Moda Health Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $660.69 | Professional | None | $331.13 | $331.13 | $660.69 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $575.44 Typical High $575.44 | Professional | None | $81.28 | $575.44 | $575.44 |
Providence Setting Facility Modifier None Typical Low $323.59 Median $446.68 Typical High $776.25 | Facility | None | $323.59 | $446.68 | $776.25 |
Providence Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $446.68 | Professional | None | $331.13 | $331.13 | $446.68 |
United Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $954.99 | Facility | None | $467.74 | $467.74 | $954.99 |
United Setting Professional Modifier None Typical Low $295.12 Median $446.68 Typical High $524.81 | Professional | None | $295.12 | $446.68 | $524.81 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $165.96 Median $165.96 Typical High $331.13 | Professional | 52 · Reduced service | $165.96 | $165.96 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $131.83 | Professional | 53 · Discontinued | $66.07 | $66.07 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $100.00 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $66.07 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $66.07 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $165.96 Typical High $331.13 | Professional | 52 · Reduced service | $165.96 | $165.96 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $131.83 | Professional | 53 · Discontinued | $66.07 | $66.07 | $131.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $100.00 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $66.07 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $66.07 |
Where Texas sits
The same service costs 2.8 times more in Iowa 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· 25th of 51
$468
IA $933DE $331
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.