How much rates vary
Facilitymedian $295 · 10th to 90th $162 to $550Professionalmedian $151 · 10th to 90th $126 to $1,096
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 $151.36 Median $151.36 Typical High $158.49 | Facility | None | $151.36 | $151.36 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $162.18 | Professional | None | $151.36 | $151.36 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
BCBS Texas Setting Facility Modifier None Typical Low $194.98 Median $263.03 Typical High $707.95 | Facility | None | $194.98 | $263.03 | $707.95 |
BCBS Texas Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Christus Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $239.88 Typical High $407.38 | Facility | None | $125.89 | $239.88 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Lucent Health Setting Professional Modifier None Typical Low $660.69 Median $1,096.48 Typical High $1,096.48 | Professional | None | $660.69 | $1,096.48 | $1,096.48 |
Moda Health Setting Facility Modifier None Typical Low $72.44 Median $213.80 Typical High $549.54 | Facility | None | $72.44 | $213.80 | $549.54 |
Moda Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $173.78 | Professional | None | $151.36 | $151.36 | $173.78 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $151.36 Typical High $1,096.48 | Facility | None | $144.54 | $151.36 | $1,096.48 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Wellpoint Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $75.86 Median $75.86 Typical High $77.62 | Professional | 52 · Reduced service | $75.86 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $30.90 | Professional | 53 · Discontinued | $30.20 | $30.20 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $23.44 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $15.49 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $15.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $75.86 Typical High $77.62 | Professional | 52 · Reduced service | $75.86 | $75.86 | $77.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $30.90 | Professional | 53 · Discontinued | $30.20 | $30.20 | $30.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $23.44 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $23.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $15.49 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $15.49 |
Where Texas sits
The same service costs 2.9 times more in Wyoming than in North Carolina. 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· 21st of 51
$151
WY $339NC $117
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.