How much rates vary
Facilitymedian $275 · 10th to 90th $178 to $427Professionalmedian $257 · 10th to 90th $182 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 $181.97 Median $181.97 Typical High $194.98 | Facility | None | $181.97 | $181.97 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $363.08 | Professional | None | $181.97 | $181.97 | $363.08 |
BCBS Texas Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Christus Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $275.42 | Professional | None | $199.53 | $199.53 | $275.42 |
Lucent Health Setting Professional Modifier None Typical Low $2,691.53 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,691.53 | $3,388.44 | $3,388.44 |
Moda Health Setting Facility Modifier None Typical Low $134.90 Median $234.42 Typical High $426.58 | Facility | None | $134.90 | $234.42 | $426.58 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $363.08 | Professional | None | $181.97 | $181.97 | $363.08 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $218.78 Typical High $218.78 | Professional | None | $81.28 | $218.78 | $218.78 |
Providence Setting Facility Modifier None Typical Low $177.83 Median $275.42 Typical High $426.58 | Facility | None | $177.83 | $275.42 | $426.58 |
Providence Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $275.42 | Professional | None | $199.53 | $199.53 | $275.42 |
United Setting Facility Modifier None Typical Low $218.78 Median $275.42 Typical High $478.63 | Facility | None | $218.78 | $275.42 | $478.63 |
United Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $309.03 | Professional | None | $173.78 | $257.04 | $309.03 |
Wellpoint Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
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 $91.20 Median $91.20 Typical High $181.97 | Professional | 52 · Reduced service | $91.20 | $91.20 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $72.44 | Professional | 53 · Discontinued | $36.31 | $36.31 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $54.95 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $36.31 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $36.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $91.20 Typical High $181.97 | Professional | 52 · Reduced service | $91.20 | $91.20 | $181.97 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $72.44 | Professional | 53 · Discontinued | $36.31 | $36.31 | $72.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $26.92 Typical High $54.95 | Professional | 55 · Aftercare only | $26.92 | $26.92 | $54.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $36.31 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $36.31 |
Where Texas sits
The same service costs 2.9 times more in Hawaii than in Florida. 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· 34th of 51
$263
HI $617FL $214
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.