How much rates vary
Facilitymedian $112 · 10th to 90th $69 to $295Professionalmedian $100 · 10th to 90th $74 to $100
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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $102.33 | Professional | None | $75.86 | $100.00 | $102.33 |
BCBS Texas Setting Facility Modifier None Typical Low $72.44 Median $181.97 Typical High $338.84 | Facility | None | $72.44 | $181.97 | $338.84 |
BCBS Texas Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Christus Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $144.54 Typical High $302.00 | Facility | None | $85.11 | $144.54 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Moda Health Setting Facility Modifier None Typical Low $74.13 Median $128.82 Typical High $354.81 | Facility | None | $74.13 | $128.82 | $354.81 |
Moda Health Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $109.65 | Professional | None | $75.86 | $100.00 | $109.65 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Providence Setting Facility Modifier None Typical Low $74.13 Median $107.15 Typical High $794.33 | Facility | None | $74.13 | $107.15 | $794.33 |
Providence Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $100.00 | Professional | None | $81.28 | $100.00 | $100.00 |
Wellpoint Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
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 $38.02 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $38.02 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $15.14 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $11.48 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.59 | $10.00 | $10.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $50.12 | $50.12 | $50.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $19.95 | $19.95 | $19.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $15.14 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $10.00 |
Where Texas sits
The same service costs 2.9 times more in Arizona 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· 5th of 51
$100
AZ $115AL $39.81
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.