How much rates vary
Facilitymedian $398 · 10th to 90th $363 to $871Professionalmedian $407 · 10th to 90th $295 to $6,607
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 $380.19 Median $380.19 Typical High $407.38 | Facility | None | $380.19 | $380.19 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $758.58 | Professional | None | $380.19 | $380.19 | $758.58 |
BCBS Texas Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Christus Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Lucent Health Setting Professional Modifier None Typical Low $4,365.16 Median $6,606.93 Typical High $6,606.93 | Professional | None | $4,365.16 | $6,606.93 | $6,606.93 |
Moda Health Setting Facility Modifier None Typical Low $208.93 Median $478.63 Typical High $870.96 | Facility | None | $208.93 | $478.63 | $870.96 |
Moda Health Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $758.58 | Professional | None | $380.19 | $380.19 | $758.58 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $645.65 Typical High $645.65 | Professional | None | $81.28 | $645.65 | $645.65 |
Providence Setting Facility Modifier None Typical Low $371.54 Median $398.11 Typical High $870.96 | Facility | None | $371.54 | $398.11 | $870.96 |
Providence Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
United Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $870.96 | Facility | None | $371.54 | $371.54 | $870.96 |
United Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $489.78 | Professional | None | $269.15 | $407.38 | $489.78 |
Wellpoint Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
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 $186.21 Median $186.21 Typical High $380.19 | Professional | 52 · Reduced service | $186.21 | $186.21 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $151.36 | Professional | 53 · Discontinued | $75.86 | $75.86 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $112.20 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $75.86 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $75.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $186.21 Typical High $380.19 | Professional | 52 · Reduced service | $186.21 | $186.21 | $380.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $151.36 | Professional | 53 · Discontinued | $75.86 | $75.86 | $151.36 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $112.20 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $112.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $75.86 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $75.86 |
Where Texas sits
The same service costs 2.8 times more in Wisconsin 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· 35th of 51
$407
WI $851FL $309
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.