How much rates vary
Facilitymedian $93 · 10th to 90th $19 to $245Professionalmedian $16 · 10th to 90th $10 to $30
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 $10.00 Median $10.00 Typical High $21.88 | Facility | None | $10.00 | $10.00 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $31.62 | Professional | None | $10.00 | $10.00 | $31.62 |
Ambetter Setting Professional Modifier None Typical Low $10.00 Median $18.20 Typical High $21.38 | Professional | None | $10.00 | $18.20 | $21.38 |
BCBS Texas Setting Facility Modifier None Typical Low $63.10 Median $165.96 Typical High $316.23 | Facility | None | $63.10 | $165.96 | $316.23 |
BCBS Texas Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
Baylor Scott & White Setting Facility Modifier None Typical Low $6.03 Median $57.54 Typical High $218.78 | Facility | None | $6.03 | $57.54 | $218.78 |
Christus Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Cigna Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $20.89 Typical High $30.20 | Professional | None | $13.80 | $20.89 | $30.20 |
Health Smart Setting Professional Modifier None Typical Low $16.60 Median $25.70 Typical High $30.90 | Professional | None | $16.60 | $25.70 | $30.90 |
Lucent Health Setting Professional Modifier None Typical Low $16.60 Median $25.70 Typical High $30.90 | Professional | None | $16.60 | $25.70 | $30.90 |
Moda Health Setting Facility Modifier None Typical Low $24.55 Median $93.33 Typical High $204.17 | Facility | None | $24.55 | $93.33 | $204.17 |
Moda Health Setting Professional Modifier None Typical Low $10.00 Median $10.72 Typical High $36.31 | Professional | None | $10.00 | $10.72 | $36.31 |
Molina Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.80 | Professional | None | $13.18 | $13.18 | $13.80 |
Oscar Health Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $478.63 | Facility | None | $28.18 | $28.18 | $478.63 |
Providence Setting Facility Modifier None Typical Low $10.00 Median $14.45 Typical High $28.84 | Facility | None | $10.00 | $14.45 | $28.84 |
Providence Setting Professional Modifier None Typical Low $13.49 Median $20.89 Typical High $30.20 | Professional | None | $13.49 | $20.89 | $30.20 |
United Setting Facility Modifier None Typical Low $109.65 Median $112.20 Typical High $151.36 | Facility | None | $109.65 | $112.20 | $151.36 |
United Setting Professional Modifier None Typical Low $12.30 Median $23.99 Typical High $30.20 | Professional | None | $12.30 | $23.99 | $30.20 |
Wellpoint Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
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 $5.01 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $2.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $1.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $5.01 | $5.01 | $5.01 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $2.00 | $2.00 | $2.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $1.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $1.00 |
Where Texas sits
The same service costs 5.4 times more in Vermont than in Kansas. 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· 2nd of 51
$63.10
VT $75.86KS $14.13
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.