How much rates vary
Facilitymedian $316 · 10th to 90th $87 to $8,318Professionalmedian $105 · 10th to 90th $74 to $724
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 $83.18 Median $85.11 Typical High $85.11 | Facility | None | $83.18 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $83.18 Typical High $85.11 | Professional | None | $79.43 | $83.18 | $85.11 |
BCBS Texas Setting Facility Modifier None Typical Low $81.28 Median $190.55 Typical High $380.19 | Facility | None | $81.28 | $190.55 | $380.19 |
BCBS Texas Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $724.44 | Professional | None | $512.86 | $724.44 | $724.44 |
Moda Health Setting Facility Modifier None Typical Low $79.43 Median $85.11 Typical High $123.03 | Facility | None | $79.43 | $85.11 | $123.03 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $83.18 Typical High $85.11 | Professional | None | $79.43 | $83.18 | $85.11 |
Oscar Health Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,023.29 | Professional | None | $758.58 | $851.14 | $1,023.29 |
Providence Setting Facility Modifier None Typical Low $79.43 Median $85.11 Typical High $123.03 | Facility | None | $79.43 | $85.11 | $123.03 |
Providence Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
United Setting Facility Modifier None Typical Low $501.19 Median $2,754.23 Typical High $10,964.78 | Facility | None | $501.19 | $2,754.23 | $10,964.78 |
United Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $128.82 | Professional | None | $64.57 | $87.10 | $128.82 |
Wellpoint Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
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 $39.81 Median $41.69 Typical High $42.66 | Professional | 52 · Reduced service | $39.81 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $15.85 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.59 Typical High $12.88 | Professional | 55 · Aftercare only | $12.02 | $12.59 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.32 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.94 | $8.32 | $8.51 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $41.69 Typical High $42.66 | Professional | 52 · Reduced service | $39.81 | $41.69 | $42.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $15.85 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.59 Typical High $12.88 | Professional | 55 · Aftercare only | $12.02 | $12.59 | $12.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.32 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.94 | $8.32 | $8.51 |
Where Texas sits
The same service costs 12.6 times more in California than in Kentucky. 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· 19th of 51
$107
CA $245KY $19.50
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.