How much rates vary
Facilitymedian $316 · 10th to 90th $214 to $525Professionalmedian $295 · 10th to 90th $229 to $3,388
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 $229.09 Median $229.09 Typical High $245.47 | Facility | None | $229.09 | $229.09 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $457.09 | Professional | None | $229.09 | $229.09 | $457.09 |
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 $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Lucent Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,630.27 | $3,388.44 | $3,388.44 |
Moda Health Setting Facility Modifier None Typical Low $141.25 Median $288.40 Typical High $524.81 | Facility | None | $141.25 | $288.40 | $524.81 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $457.09 | Professional | None | $229.09 | $229.09 | $457.09 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $295.12 Typical High $295.12 | Professional | None | $81.28 | $295.12 | $295.12 |
Providence Setting Facility Modifier None Typical Low $223.87 Median $316.23 Typical High $524.81 | Facility | None | $223.87 | $316.23 | $524.81 |
Providence Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
United Setting Facility Modifier None Typical Low $213.80 Median $257.04 Typical High $512.86 | Facility | None | $213.80 | $257.04 | $512.86 |
United Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $331.13 | Professional | None | $181.97 | $275.42 | $331.13 |
Wellpoint Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
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 $112.20 Median $112.20 Typical High $229.09 | Professional | 52 · Reduced service | $112.20 | $112.20 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $91.20 | Professional | 53 · Discontinued | $45.71 | $45.71 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $67.61 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $45.71 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $45.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $112.20 Typical High $229.09 | Professional | 52 · Reduced service | $112.20 | $112.20 | $229.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $91.20 | Professional | 53 · Discontinued | $45.71 | $45.71 | $91.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $67.61 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $67.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $45.71 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $45.71 |
Where Texas sits
The same service costs 2.5 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
$295
HI $562DE $229
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.