How much rates vary
Facilitymedian $331 · 10th to 90th $76 to $813Professionalmedian $95 · 10th to 90th $18 to $794
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 $53.70 Median $70.79 Typical High $75.86 | Facility | None | $53.70 | $70.79 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $7.94 Median $58.88 Typical High $75.86 | Professional | None | $7.94 | $58.88 | $75.86 |
Ambetter Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $44.67 | Professional | None | $35.48 | $35.48 | $44.67 |
BCBS Texas Setting Facility Modifier None Typical Low $234.42 Median $489.78 Typical High $831.76 | Facility | None | $234.42 | $489.78 | $831.76 |
BCBS Texas Setting Professional Modifier None Typical Low $51.29 Median $125.89 Typical High $128.82 | Professional | None | $51.29 | $125.89 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $186.21 Typical High $281.84 | Facility | None | $61.66 | $186.21 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $48.98 Typical High $162.18 | Professional | None | $40.74 | $48.98 | $162.18 |
Lucent Health Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $794.33 | Professional | None | $588.84 | $794.33 | $794.33 |
Moda Health Setting Facility Modifier None Typical Low $54.95 Median $75.86 Typical High $100.00 | Facility | None | $54.95 | $75.86 | $100.00 |
Moda Health Setting Professional Modifier None Typical Low $7.94 Median $58.88 Typical High $112.20 | Professional | None | $7.94 | $58.88 | $112.20 |
Molina Setting Professional Modifier None Typical Low $15.14 Median $83.18 Typical High $109.65 | Professional | None | $15.14 | $83.18 | $109.65 |
Providence Setting Facility Modifier None Typical Low $67.61 Median $138.04 Typical High $281.84 | Facility | None | $67.61 | $138.04 | $281.84 |
Providence Setting Professional Modifier None Typical Low $40.74 Median $48.98 Typical High $165.96 | Professional | None | $40.74 | $48.98 | $165.96 |
United Setting Facility Modifier None Typical Low $257.04 Median $269.15 Typical High $354.81 | Facility | None | $257.04 | $269.15 | $354.81 |
United Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $199.53 | Professional | None | $56.23 | $75.86 | $199.53 |
Wellpoint Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $91.20 | Professional | None | $38.90 | $38.90 | $91.20 |
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 $27.54 Median $28.84 Typical High $38.02 | Professional | 52 · Reduced service | $27.54 | $28.84 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $11.75 Typical High $15.14 | Professional | 53 · Discontinued | $10.96 | $11.75 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.71 Typical High $11.22 | Professional | 55 · Aftercare only | $8.13 | $8.71 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.89 Typical High $7.59 | Professional | 56 · Pre-op care only | $5.50 | $5.89 | $7.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $28.84 Typical High $38.02 | Professional | 52 · Reduced service | $26.92 | $28.84 | $38.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $11.75 Typical High $15.14 | Professional | 53 · Discontinued | $10.96 | $11.75 | $15.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.71 Typical High $11.22 | Professional | 55 · Aftercare only | $8.13 | $8.71 | $11.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.89 Typical High $7.59 | Professional | 56 · Pre-op care only | $5.37 | $5.89 | $7.59 |
Where Texas sits
The same service costs 5.0 times more in Alaska than in Alabama. 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· 21st of 51
$107
AK $269AL $53.70
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.