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 $323.59 Median $323.59 Typical High $346.74 | Facility | None | $323.59 | $323.59 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $645.65 | Professional | None | $323.59 | $323.59 | $645.65 |
BCBS Texas Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Christus Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $562.34 | Professional | None | $407.38 | $407.38 | $562.34 |
Lucent Health Setting Professional Modifier None Typical Low $3,890.45 Median $5,128.61 Typical High $5,128.61 | Professional | None | $3,890.45 | $5,128.61 | $5,128.61 |
Moda Health Setting Facility Modifier None Typical Low $213.80 Median $416.87 Typical High $741.31 | Facility | None | $213.80 | $416.87 | $741.31 |
Moda Health Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $645.65 | Professional | None | $323.59 | $323.59 | $645.65 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $549.54 Typical High $549.54 | Professional | None | $81.28 | $549.54 | $549.54 |
Providence Setting Facility Modifier None Typical Low $316.23 Median $562.34 Typical High $741.31 | Facility | None | $316.23 | $562.34 | $741.31 |
Providence Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $562.34 | Professional | None | $407.38 | $407.38 | $562.34 |
United Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $912.01 | Facility | None | $776.25 | $776.25 | $912.01 |
United Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $501.19 | Professional | None | $275.42 | $416.87 | $501.19 |
Wellpoint Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
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 $47.86 Median $47.86 Typical High $95.50 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $64.57 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $64.57 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $95.50 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $95.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $64.57 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $64.57 |
Where Texas sits
The same service costs 2.6 times more in Hawaii than in New Jersey. 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· 29th of 51
$437
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.