How much rates vary
Facilitymedian $195 · 10th to 90th $126 to $309Professionalmedian $166 · 10th to 90th $132 to $2,291
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 $131.83 Median $131.83 Typical High $141.25 | Facility | None | $131.83 | $131.83 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $263.03 | Professional | None | $131.83 | $131.83 | $263.03 |
BCBS Texas Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Christus Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $194.98 | Professional | None | $141.25 | $141.25 | $194.98 |
Lucent Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,698.24 | $2,290.87 | $2,290.87 |
Moda Health Setting Facility Modifier None Typical Low $72.44 Median $169.82 Typical High $309.03 | Facility | None | $72.44 | $169.82 | $309.03 |
Moda Health Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $263.03 | Professional | None | $131.83 | $131.83 | $263.03 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $177.83 Typical High $177.83 | Professional | None | $81.28 | $177.83 | $177.83 |
Providence Setting Facility Modifier None Typical Low $128.82 Median $194.98 Typical High $309.03 | Facility | None | $128.82 | $194.98 | $309.03 |
Providence Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $194.98 | Professional | None | $141.25 | $141.25 | $194.98 |
United Setting Facility Modifier None Typical Low $151.36 Median $158.49 Typical High $263.03 | Facility | None | $151.36 | $158.49 | $263.03 |
United Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $169.82 | Professional | None | $93.33 | $141.25 | $169.82 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
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 $66.07 Median $66.07 Typical High $131.83 | Professional | 52 · Reduced service | $66.07 | $66.07 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $52.48 | Professional | 53 · Discontinued | $26.30 | $26.30 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $39.81 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $26.30 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $26.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $66.07 Typical High $131.83 | Professional | 52 · Reduced service | $66.07 | $66.07 | $131.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $52.48 | Professional | 53 · Discontinued | $26.30 | $26.30 | $52.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $39.81 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $39.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $26.30 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $26.30 |
Where Texas sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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· 22nd of 51
$170
HI $407DC $129
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.