How much rates vary
Facilitymedian $155 · 10th to 90th $79 to $1,950Professionalmedian $120 · 10th to 90th $23 to $912
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 $79.43 Median $102.33 Typical High $128.82 | Facility | None | $79.43 | $102.33 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $102.33 Typical High $131.83 | Professional | None | $72.44 | $102.33 | $131.83 |
BCBS Texas Setting Facility Modifier None Typical Low $74.13 Median $125.89 Typical High $1,380.38 | Facility | None | $74.13 | $125.89 | $1,380.38 |
BCBS Texas Setting Professional Modifier None Typical Low $83.18 Median $123.03 Typical High $199.53 | Professional | None | $83.18 | $123.03 | $199.53 |
Christus Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $114.82 Typical High $165.96 | Facility | None | $66.07 | $114.82 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $128.82 Typical High $165.96 | Professional | None | $93.33 | $128.82 | $165.96 |
Lucent Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,202.26 | Professional | None | $912.01 | $912.01 | $1,202.26 |
Moda Health Setting Facility Modifier None Typical Low $79.43 Median $117.49 Typical High $173.78 | Facility | None | $79.43 | $117.49 | $173.78 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $102.33 Typical High $141.25 | Professional | None | $79.43 | $102.33 | $141.25 |
Molina Setting Professional Modifier None Typical Low $19.95 Median $109.65 Typical High $147.91 | Professional | None | $19.95 | $109.65 | $147.91 |
Oscar Health Setting Professional Modifier None Typical Low $109.65 Median $288.40 Typical High $501.19 | Professional | None | $109.65 | $288.40 | $501.19 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $120.23 Typical High $173.78 | Facility | None | $66.07 | $120.23 | $173.78 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $165.96 | Professional | None | $91.20 | $128.82 | $165.96 |
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 $72.44 Median $104.71 Typical High $158.49 | Professional | None | $72.44 | $104.71 | $158.49 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
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 $36.31 Median $51.29 Typical High $64.57 | Professional | 52 · Reduced service | $36.31 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $20.42 Typical High $25.70 | Professional | 53 · Discontinued | $14.45 | $20.42 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $15.49 Typical High $19.50 | Professional | 55 · Aftercare only | $10.72 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $10.23 Typical High $12.88 | Professional | 56 · Pre-op care only | $7.24 | $10.23 | $12.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $51.29 Typical High $63.10 | Professional | 52 · Reduced service | $36.31 | $51.29 | $63.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $20.42 Typical High $25.12 | Professional | 53 · Discontinued | $14.45 | $20.42 | $25.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $15.49 Typical High $18.62 | Professional | 55 · Aftercare only | $10.72 | $15.49 | $18.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $10.23 Typical High $12.59 | Professional | 56 · Pre-op care only | $7.24 | $10.23 | $12.59 |
Where Texas sits
The same service costs 3.6 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· 36th of 51
$120
AK $355KY $97.72
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.