How much rates vary
Facilitymedian $138 · 10th to 90th $51 to $1,950Professionalmedian $54 · 10th to 90th $12 to $407
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 $31.62 Median $35.48 Typical High $56.23 | Facility | None | $31.62 | $35.48 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $44.67 Typical High $54.95 | Professional | None | $28.18 | $44.67 | $54.95 |
BCBS Texas Setting Facility Modifier None Typical Low $52.48 Median $100.00 Typical High $478.63 | Facility | None | $52.48 | $100.00 | $478.63 |
BCBS Texas Setting Professional Modifier None Typical Low $32.36 Median $52.48 Typical High $87.10 | Professional | None | $32.36 | $52.48 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $52.48 Typical High $70.79 | Professional | None | $37.15 | $52.48 | $70.79 |
Lucent Health Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $512.86 | Professional | None | $407.38 | $407.38 | $512.86 |
Moda Health Setting Facility Modifier None Typical Low $30.20 Median $50.12 Typical High $74.13 | Facility | None | $30.20 | $50.12 | $74.13 |
Moda Health Setting Professional Modifier None Typical Low $28.18 Median $44.67 Typical High $56.23 | Professional | None | $28.18 | $44.67 | $56.23 |
Molina Setting Professional Modifier None Typical Low $10.00 Median $54.95 Typical High $74.13 | Professional | None | $10.00 | $54.95 | $74.13 |
Oscar Health Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $223.87 | Professional | None | $112.20 | $117.49 | $223.87 |
Providence Setting Facility Modifier None Typical Low $31.62 Median $58.88 Typical High $151.36 | Facility | None | $31.62 | $58.88 | $151.36 |
Providence Setting Professional Modifier None Typical Low $37.15 Median $51.29 Typical High $70.79 | Professional | None | $37.15 | $51.29 | $70.79 |
United Setting Facility Modifier None Typical Low $138.04 Median $741.31 Typical High $2,187.76 | Facility | None | $138.04 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $27.54 Median $41.69 Typical High $64.57 | Professional | None | $27.54 | $41.69 | $64.57 |
Wellpoint Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
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 $14.13 Median $22.39 Typical High $28.18 | Professional | 52 · Reduced service | $14.13 | $22.39 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $8.91 Typical High $11.22 | Professional | 53 · Discontinued | $5.75 | $8.91 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $6.61 Typical High $8.32 | Professional | 55 · Aftercare only | $4.27 | $6.61 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $4.47 Typical High $5.62 | Professional | 56 · Pre-op care only | $2.82 | $4.47 | $5.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $22.39 Typical High $26.92 | Professional | 52 · Reduced service | $14.13 | $22.39 | $26.92 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $8.91 Typical High $10.72 | Professional | 53 · Discontinued | $5.75 | $8.91 | $10.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $6.61 Typical High $7.94 | Professional | 55 · Aftercare only | $4.27 | $6.61 | $7.94 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $4.47 Typical High $5.37 | Professional | 56 · Pre-op care only | $2.82 | $4.47 | $5.37 |
Where Texas sits
The same service costs 3.7 times more in Alaska 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· 31st of 51
$54.95
AK $148KY $39.81
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.