How much rates vary
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 $389.05 Median $389.05 Typical High $416.87 | Facility | None | $389.05 | $389.05 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $776.25 | Professional | None | $389.05 | $389.05 | $776.25 |
BCBS Texas Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $524.81 | Professional | None | $416.87 | $416.87 | $524.81 |
Christus Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
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 $4,570.88 Median $6,165.95 Typical High $6,165.95 | Professional | None | $4,570.88 | $6,165.95 | $6,165.95 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $489.78 Typical High $891.25 | Facility | None | $257.04 | $489.78 | $891.25 |
Moda Health Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $776.25 | Professional | None | $389.05 | $389.05 | $776.25 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $660.69 Typical High $660.69 | Professional | None | $81.28 | $660.69 | $660.69 |
Providence Setting Facility Modifier None Typical Low $380.19 Median $524.81 Typical High $891.25 | Facility | None | $380.19 | $524.81 | $891.25 |
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 $933.25 Median $933.25 Typical High $1,096.48 | Facility | None | $933.25 | $933.25 | $1,096.48 |
United Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $602.56 | Professional | None | $331.13 | $501.19 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
4 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 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $114.82 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $77.62 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $77.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $114.82 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $114.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $77.62 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $77.62 |
Where Texas sits
The same service costs 3.2 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· 31st of 51
$525
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.