How much rates vary
Facilitymedian $708 · 10th to 90th $398 to $955Professionalmedian $603 · 10th to 90th $407 to $6,918
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 $407.38 Median $407.38 Typical High $436.52 | Facility | None | $407.38 | $407.38 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $812.83 | Professional | None | $407.38 | $407.38 | $812.83 |
BCBS Texas Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $549.54 | Professional | None | $446.68 | $549.54 | $549.54 |
Christus Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $707.95 | Professional | None | $602.56 | $602.56 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $4,677.35 Median $6,918.31 Typical High $6,918.31 | Professional | None | $4,677.35 | $6,918.31 | $6,918.31 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $524.81 Typical High $954.99 | Facility | None | $257.04 | $524.81 | $954.99 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $812.83 | Professional | None | $407.38 | $407.38 | $812.83 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $524.81 Typical High $524.81 | Professional | None | $81.28 | $524.81 | $524.81 |
Providence Setting Facility Modifier None Typical Low $398.11 Median $707.95 Typical High $954.99 | Facility | None | $398.11 | $707.95 | $954.99 |
Providence Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $707.95 | Professional | None | $602.56 | $602.56 | $707.95 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $1,071.52 | Facility | None | $398.11 | $398.11 | $1,071.52 |
United Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $588.84 | Professional | None | $331.13 | $501.19 | $588.84 |
Wellpoint Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
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 $204.17 Median $204.17 Typical High $407.38 | Professional | 52 · Reduced service | $204.17 | $204.17 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $162.18 | Professional | 53 · Discontinued | $81.28 | $81.28 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $123.03 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $81.28 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $81.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $204.17 Typical High $407.38 | Professional | 52 · Reduced service | $204.17 | $204.17 | $407.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $162.18 | Professional | 53 · Discontinued | $81.28 | $81.28 | $162.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $123.03 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $123.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $81.28 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $81.28 |
Where Texas sits
The same service costs 2.0 times more in Iowa 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· 31st of 51
$603
IA $891FL $447
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.