How much rates vary
Facilitymedian $71 · 10th to 90th $20 to $1,950Professionalmedian $30 · 10th to 90th $6 to $331
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 $17.38 Median $19.95 Typical High $32.36 | Facility | None | $17.38 | $19.95 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $28.84 Typical High $34.67 | Professional | None | $15.85 | $28.84 | $34.67 |
Ambetter Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
BCBS Texas Setting Facility Modifier None Typical Low $18.62 Median $31.62 Typical High $426.58 | Facility | None | $18.62 | $31.62 | $426.58 |
BCBS Texas Setting Professional Modifier None Typical Low $14.45 Median $25.70 Typical High $79.43 | Professional | None | $14.45 | $25.70 | $79.43 |
Christus Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
Cigna Setting Facility Modifier None Typical Low $18.20 Median $25.70 Typical High $66.07 | Facility | None | $18.20 | $25.70 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $32.36 Typical High $54.95 | Professional | None | $18.20 | $32.36 | $54.95 |
Lucent Health Setting Professional Modifier None Typical Low $331.13 Median $346.74 Typical High $346.74 | Professional | None | $331.13 | $346.74 | $346.74 |
Moda Health Setting Facility Modifier None Typical Low $15.49 Median $30.20 Typical High $64.57 | Facility | None | $15.49 | $30.20 | $64.57 |
Moda Health Setting Professional Modifier None Typical Low $15.85 Median $28.84 Typical High $34.67 | Professional | None | $15.85 | $28.84 | $34.67 |
Molina Setting Professional Modifier None Typical Low $4.90 Median $27.54 Typical High $36.31 | Professional | None | $4.90 | $27.54 | $36.31 |
Providence Setting Facility Modifier None Typical Low $18.62 Median $26.92 Typical High $66.07 | Facility | None | $18.62 | $26.92 | $66.07 |
Providence Setting Professional Modifier None Typical Low $18.20 Median $31.62 Typical High $53.70 | Professional | None | $18.20 | $31.62 | $53.70 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $15.85 Median $30.90 Typical High $54.95 | Professional | None | $15.85 | $30.90 | $54.95 |
Wellpoint Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
9 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 $7.94 Median $14.45 Typical High $18.20 | Professional | 52 · Reduced service | $7.94 | $14.45 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $5.75 Typical High $7.24 | Professional | 53 · Discontinued | $3.16 | $5.75 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $4.27 Typical High $5.37 | Professional | 55 · Aftercare only | $2.40 | $4.27 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $2.88 Typical High $3.63 | Professional | 56 · Pre-op care only | $1.58 | $2.88 | $3.63 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 59 · Distinct service | $30.20 | $30.20 | $30.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.94 Median $14.45 Typical High $17.38 | Professional | 52 · Reduced service | $7.94 | $14.45 | $17.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $5.75 Typical High $6.92 | Professional | 53 · Discontinued | $3.16 | $5.75 | $6.92 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $4.27 Typical High $5.13 | Professional | 55 · Aftercare only | $2.40 | $4.27 | $5.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $2.88 Typical High $3.47 | Professional | 56 · Pre-op care only | $1.58 | $2.88 | $3.47 |
Where Texas sits
The same service costs 3.5 times more in Alaska than in Virginia. 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· 46th of 51
$30.90
AK $83.18VA $23.99
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.