How much rates vary
Facilitymedian $87 · 10th to 90th $15 to $1,585Professionalmedian $25 · 10th to 90th $14 to $214
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 $16.22 Median $22.91 Typical High $29.51 | Facility | None | $16.22 | $22.91 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $23.44 Typical High $35.48 | Professional | None | $14.79 | $23.44 | $35.48 |
Ambetter Setting Professional Modifier None Typical Low $14.45 Median $27.54 Typical High $28.84 | Professional | None | $14.45 | $27.54 | $28.84 |
BCBS Texas Setting Facility Modifier None Typical Low $13.18 Median $23.44 Typical High $128.82 | Facility | None | $13.18 | $23.44 | $128.82 |
BCBS Texas Setting Professional Modifier None Typical Low $14.13 Median $22.91 Typical High $38.02 | Professional | None | $14.13 | $22.91 | $38.02 |
Christus Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $14.13 Median $19.95 Typical High $66.07 | Facility | None | $14.13 | $19.95 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $27.54 Typical High $41.69 | Professional | None | $18.20 | $27.54 | $41.69 |
Health Smart Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Lucent Health Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $239.88 | Professional | None | $213.80 | $213.80 | $239.88 |
Moda Health Setting Facility Modifier None Typical Low $15.14 Median $28.18 Typical High $288.40 | Facility | None | $15.14 | $28.18 | $288.40 |
Moda Health Setting Professional Modifier None Typical Low $14.79 Median $23.44 Typical High $35.48 | Professional | None | $14.79 | $23.44 | $35.48 |
Molina Setting Professional Modifier None Typical Low $13.80 Median $17.38 Typical High $23.99 | Professional | None | $13.80 | $17.38 | $23.99 |
Oscar Health Setting Professional Modifier None Typical Low $30.20 Median $58.88 Typical High $104.71 | Professional | None | $30.20 | $58.88 | $104.71 |
Providence Setting Facility Modifier None Typical Low $15.14 Median $21.38 Typical High $66.07 | Facility | None | $15.14 | $21.38 | $66.07 |
Providence Setting Professional Modifier None Typical Low $18.20 Median $27.54 Typical High $40.74 | Professional | None | $18.20 | $27.54 | $40.74 |
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 $15.49 Median $26.30 Typical High $44.67 | Professional | None | $15.49 | $26.30 | $44.67 |
Wellpoint Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
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 $7.41 Median $11.75 Typical High $14.79 | Professional | 52 · Reduced service | $7.41 | $11.75 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $4.68 Typical High $5.89 | Professional | 53 · Discontinued | $2.95 | $4.68 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $3.55 Typical High $4.47 | Professional | 55 · Aftercare only | $2.19 | $3.55 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $2.34 Typical High $2.95 | Professional | 56 · Pre-op care only | $1.48 | $2.34 | $2.95 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 50 · Both sides | $38.90 | $38.90 | $38.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.41 Median $11.75 Typical High $14.13 | Professional | 52 · Reduced service | $7.41 | $11.75 | $14.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $4.68 Typical High $5.75 | Professional | 53 · Discontinued | $2.95 | $4.68 | $5.75 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $3.55 Typical High $4.27 | Professional | 55 · Aftercare only | $2.19 | $3.55 | $4.27 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $2.34 Typical High $2.88 | Professional | 56 · Pre-op care only | $1.48 | $2.34 | $2.88 |
Where Texas sits
The same service costs 3.0 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· 48th of 51
$25.70
AK $69.18VA $22.91
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.