How much rates vary
Facilitymedian $129 · 10th to 90th $65 to $1,738Professionalmedian $60 · 10th to 90th $11 to $562
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 $13.49 Median $16.60 Typical High $79.43 | Facility | None | $13.49 | $16.60 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $64.57 Typical High $85.11 | Professional | None | $13.49 | $64.57 | $85.11 |
Ambetter Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $70.79 | Professional | None | $13.18 | $13.18 | $70.79 |
BCBS Texas Setting Facility Modifier None Typical Low $64.57 Median $104.71 Typical High $630.96 | Facility | None | $64.57 | $104.71 | $630.96 |
BCBS Texas Setting Professional Modifier None Typical Low $12.88 Median $56.23 Typical High $112.20 | Professional | None | $12.88 | $56.23 | $112.20 |
Christus Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $83.18 Typical High $512.86 | Facility | None | $61.66 | $83.18 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $51.29 Typical High $109.65 | Professional | None | $16.22 | $51.29 | $109.65 |
Lucent Health Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $645.65 | Professional | None | $562.34 | $645.65 | $645.65 |
Moda Health Setting Facility Modifier None Typical Low $13.18 Median $24.55 Typical High $109.65 | Facility | None | $13.18 | $24.55 | $109.65 |
Moda Health Setting Professional Modifier None Typical Low $13.49 Median $67.61 Typical High $89.13 | Professional | None | $13.49 | $67.61 | $89.13 |
Molina Setting Professional Modifier None Typical Low $9.77 Median $54.95 Typical High $72.44 | Professional | None | $9.77 | $54.95 | $72.44 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $79.43 Typical High $154.88 | Facility | None | $50.12 | $79.43 | $154.88 |
Providence Setting Professional Modifier None Typical Low $16.22 Median $51.29 Typical High $109.65 | Professional | None | $16.22 | $51.29 | $109.65 |
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 $13.49 Median $52.48 Typical High $100.00 | Professional | None | $13.49 | $52.48 | $100.00 |
Wellpoint Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
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 $6.76 Median $30.90 Typical High $42.66 | Professional | 52 · Reduced service | $6.76 | $30.90 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $12.30 Typical High $16.98 | Professional | 53 · Discontinued | $2.69 | $12.30 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $9.33 Typical High $12.88 | Professional | 55 · Aftercare only | $2.00 | $9.33 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $6.31 Typical High $8.51 | Professional | 56 · Pre-op care only | $1.35 | $6.31 | $8.51 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $6.76 Median $32.36 Typical High $42.66 | Professional | 52 · Reduced service | $6.76 | $32.36 | $42.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $12.59 Typical High $16.98 | Professional | 53 · Discontinued | $2.69 | $12.59 | $16.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $9.55 Typical High $12.88 | Professional | 55 · Aftercare only | $2.00 | $9.55 | $12.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $6.46 Typical High $8.51 | Professional | 56 · Pre-op care only | $1.35 | $6.46 | $8.51 |
Where Texas sits
The same service costs 5.9 times more in Iowa 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· 33rd of 51
$63.10
IA $117KY $19.95
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.