How much rates vary
Facilitymedian $741 · 10th to 90th $145 to $2,692Professionalmedian $58 · 10th to 90th $41 to $661
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 $44.67 Median $45.71 Typical High $46.77 | Facility | None | $44.67 | $45.71 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $45.71 Typical High $50.12 | Professional | None | $43.65 | $45.71 | $50.12 |
BCBS Texas Setting Facility Modifier None Typical Low $416.87 Median $758.58 Typical High $3,388.44 | Facility | None | $416.87 | $758.58 | $3,388.44 |
BCBS Texas Setting Professional Modifier None Typical Low $42.66 Median $57.54 Typical High $134.90 | Professional | None | $42.66 | $57.54 | $134.90 |
Christus Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $758.58 Typical High $1,659.59 | Facility | None | $407.38 | $758.58 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $57.54 Typical High $85.11 | Professional | None | $48.98 | $57.54 | $85.11 |
Lucent Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Moda Health Setting Facility Modifier None Typical Low $39.81 Median $47.86 Typical High $93.33 | Facility | None | $39.81 | $47.86 | $93.33 |
Moda Health Setting Professional Modifier None Typical Low $43.65 Median $45.71 Typical High $58.88 | Professional | None | $43.65 | $45.71 | $58.88 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $30.20 Typical High $30.20 | Professional | None | $23.44 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $1,659.59 Typical High $3,981.07 | Facility | None | $66.07 | $1,659.59 | $3,981.07 |
Providence Setting Professional Modifier None Typical Low $48.98 Median $57.54 Typical High $85.11 | Professional | None | $48.98 | $57.54 | $85.11 |
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 $38.90 Median $52.48 Typical High $77.62 | Professional | None | $38.90 | $52.48 | $77.62 |
Wellpoint Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
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 $21.88 Median $22.91 Typical High $25.12 | Professional | 52 · Reduced service | $21.88 | $22.91 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.12 Typical High $10.00 | Professional | 53 · Discontinued | $8.71 | $9.12 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.92 Typical High $7.59 | Professional | 55 · Aftercare only | $6.61 | $6.92 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.57 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.37 | $4.57 | $5.01 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $22.91 Typical High $25.12 | Professional | 52 · Reduced service | $21.88 | $22.91 | $25.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.12 Typical High $10.00 | Professional | 53 · Discontinued | $8.71 | $9.12 | $10.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.92 Typical High $7.59 | Professional | 55 · Aftercare only | $6.61 | $6.92 | $7.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.57 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.37 | $4.57 | $5.01 |
Where Texas sits
The same service costs 4.7 times more in Wisconsin 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· 26th of 51
$74.13
WI $200KY $42.66
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.