How much rates vary
Facilitymedian $9,333 · 10th to 90th $6,026 to $16,218Professionalmedian $9,333 · 10th to 90th $6,918 to $109,648
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 $6,918.31 Median $6,918.31 Typical High $7,413.10 | Facility | None | $6,918.31 | $6,918.31 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $13,803.84 | Professional | None | $6,918.31 | $6,918.31 | $13,803.84 |
Ambetter Setting Professional Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $9,549.93 | Professional | None | $9,549.93 | $9,549.93 | $9,549.93 |
BCBS Texas Setting Professional Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $9,332.54 | Professional | None | $9,332.54 | $9,332.54 | $9,332.54 |
Christus Setting Facility Modifier None Typical Low $16,218.10 Median $16,218.10 Typical High $16,218.10 | Facility | None | $16,218.10 | $16,218.10 | $16,218.10 |
Cigna Setting Facility Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $9,332.54 | Facility | None | $9,332.54 | $9,332.54 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $9,332.54 | Professional | None | $6,918.31 | $6,918.31 | $9,332.54 |
Lucent Health Setting Professional Modifier None Typical Low $97,723.72 Median $109,647.82 Typical High $109,647.82 | Professional | None | $97,723.72 | $109,647.82 | $109,647.82 |
Moda Health Setting Facility Modifier None Typical Low $4,570.88 Median $8,912.51 Typical High $16,218.10 | Facility | None | $4,570.88 | $8,912.51 | $16,218.10 |
Moda Health Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $13,803.84 | Professional | None | $6,918.31 | $6,918.31 | $13,803.84 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $11,748.98 Typical High $11,748.98 | Professional | None | $81.28 | $11,748.98 | $11,748.98 |
Providence Setting Facility Modifier None Typical Low $6,760.83 Median $9,332.54 Typical High $16,218.10 | Facility | None | $6,760.83 | $9,332.54 | $16,218.10 |
Providence Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $9,332.54 | Professional | None | $6,918.31 | $6,918.31 | $9,332.54 |
United Setting Facility Modifier None Typical Low $6,025.60 Median $7,244.36 Typical High $16,595.87 | Facility | None | $6,025.60 | $7,244.36 | $16,595.87 |
United Setting Professional Modifier None Typical Low $6,025.60 Median $8,912.51 Typical High $10,715.19 | Professional | None | $6,025.60 | $8,912.51 | $10,715.19 |
Wellpoint Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $8,709.64 | Professional | None | $8,511.38 | $8,511.38 | $8,709.64 |
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 $3,467.37 Median $3,467.37 Typical High $6,918.31 | Professional | 52 · Reduced service | $3,467.37 | $3,467.37 | $6,918.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,380.38 Median $1,380.38 Typical High $2,754.23 | Professional | 53 · Discontinued | $1,380.38 | $1,380.38 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,023.29 Median $1,023.29 Typical High $2,089.30 | Professional | 55 · Aftercare only | $1,023.29 | $1,023.29 | $2,089.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $691.83 Median $691.83 Typical High $1,380.38 | Professional | 56 · Pre-op care only | $691.83 | $691.83 | $1,380.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3,467.37 Median $3,467.37 Typical High $6,918.31 | Professional | 52 · Reduced service | $3,467.37 | $3,467.37 | $6,918.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,380.38 Median $1,380.38 Typical High $2,754.23 | Professional | 53 · Discontinued | $1,380.38 | $1,380.38 | $2,754.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1,023.29 Median $1,023.29 Typical High $2,089.30 | Professional | 55 · Aftercare only | $1,023.29 | $1,023.29 | $2,089.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $691.83 Median $691.83 Typical High $1,380.38 | Professional | 56 · Pre-op care only | $691.83 | $691.83 | $1,380.38 |
Where Texas sits
The same service costs 2.8 times more in Montana 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· 24th of 51
$9,333
MT $19,498DE $6,918
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.