How much rates vary
Facilitymedian $776 · 10th to 90th $195 to $1,288Professionalmedian $148 · 10th to 90th $138 to $1,413
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 $147.91 Median $218.78 Typical High $295.12 | Facility | None | $147.91 | $218.78 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $151.36 Typical High $154.88 | Professional | None | $147.91 | $151.36 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
BCBS Texas Setting Facility Modifier None Typical Low $380.19 Median $912.01 Typical High $1,380.38 | Facility | None | $380.19 | $912.01 | $1,380.38 |
BCBS Texas Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Baylor Scott & White Setting Facility Modifier None Typical Low $213.80 Median $346.74 Typical High $524.81 | Facility | None | $213.80 | $346.74 | $524.81 |
Baylor Scott & White Setting Professional Modifier None Typical Low $141.25 Median $147.91 Typical High $346.74 | Professional | None | $141.25 | $147.91 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $288.40 Typical High $478.63 | Facility | None | $147.91 | $288.40 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Lucent Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $134.90 Median $194.98 Typical High $354.81 | Facility | None | $134.90 | $194.98 | $354.81 |
Moda Health Setting Professional Modifier None Typical Low $134.90 Median $138.04 Typical High $151.36 | Professional | None | $134.90 | $138.04 | $151.36 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $134.90 Typical High $154.88 | Professional | None | $30.20 | $134.90 | $154.88 |
Oscar Health Setting Professional Modifier None Typical Low $147.91 Median $288.40 Typical High $501.19 | Professional | None | $147.91 | $288.40 | $501.19 |
Providence Setting Facility Modifier None Typical Low $147.91 Median $213.80 Typical High $1,288.25 | Facility | None | $147.91 | $213.80 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
United Setting Professional Modifier None Typical Low $134.90 Median $144.54 Typical High $154.88 | Professional | None | $134.90 | $144.54 | $154.88 |
Wellpoint Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
13 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 Facility Modifier 52 · Reduced service Typical Low $74.13 Median $109.65 Typical High $147.91 | Facility | 52 · Reduced service | $74.13 | $109.65 | $147.91 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $29.51 Median $43.65 Typical High $58.88 | Facility | 53 · Discontinued | $29.51 | $43.65 | $58.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $22.39 Median $32.36 Typical High $44.67 | Facility | 55 · Aftercare only | $22.39 | $32.36 | $44.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.79 Median $21.88 Typical High $29.51 | Facility | 56 · Pre-op care only | $14.79 | $21.88 | $29.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $74.13 Typical High $77.62 | Professional | 52 · Reduced service | $74.13 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $30.90 | Professional | 53 · Discontinued | $29.51 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $22.91 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $15.49 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $15.49 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $125.89 Median $134.90 Typical High $162.18 | Professional | JZ · No drug discarded | $125.89 | $134.90 | $162.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $67.61 Typical High $70.79 | Professional | 52 · Reduced service | $67.61 | $67.61 | $70.79 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $28.18 | Professional | 53 · Discontinued | $26.92 | $26.92 | $28.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $20.89 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $20.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $14.13 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $14.13 |
Where Texas sits
The same service costs 2.4 times more in Wyoming than in New York. 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· 41st of 51
$148
WY $355NY $148
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.