How much rates vary
Facilitymedian $525 · 10th to 90th $302 to $832Professionalmedian $427 · 10th to 90th $355 to $5,012
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 $354.81 Median $354.81 Typical High $389.05 | Facility | None | $354.81 | $354.81 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $724.44 | Professional | None | $354.81 | $354.81 | $724.44 |
Ambetter Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
BCBS Texas Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $537.03 | Professional | None | $389.05 | $537.03 | $537.03 |
Christus Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
Cigna 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 Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $524.81 | Professional | None | $389.05 | $389.05 | $524.81 |
Lucent Health Setting Professional Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $5,011.87 | Professional | None | $4,265.80 | $5,011.87 | $5,011.87 |
Moda Health Setting Facility Modifier None Typical Low $204.17 Median $457.09 Typical High $831.76 | Facility | None | $204.17 | $457.09 | $831.76 |
Moda Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $724.44 | Professional | None | $354.81 | $354.81 | $724.44 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $407.38 Typical High $407.38 | Professional | None | $81.28 | $407.38 | $407.38 |
Providence Setting Facility Modifier None Typical Low $354.81 Median $524.81 Typical High $831.76 | Facility | None | $354.81 | $524.81 | $831.76 |
Providence Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $524.81 | Professional | None | $389.05 | $389.05 | $524.81 |
United Setting Facility Modifier None Typical Low $302.00 Median $380.19 Typical High $741.31 | Facility | None | $302.00 | $380.19 | $741.31 |
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 $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
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 $177.83 Median $177.83 Typical High $354.81 | Professional | 52 · Reduced service | $177.83 | $177.83 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $144.54 | Professional | 53 · Discontinued | $72.44 | $72.44 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $107.15 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $72.44 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $72.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $177.83 Typical High $354.81 | Professional | 52 · Reduced service | $177.83 | $177.83 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $144.54 | Professional | 53 · Discontinued | $72.44 | $72.44 | $144.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $107.15 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $107.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $72.44 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $72.44 |
Where Texas sits
The same service costs 2.3 times more in Hawaii than in Pennsylvania. 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· 28th of 51
$447
HI $851PA $363
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.