How much rates vary
Facilitymedian $45 · 10th to 90th $25 to $129Professionalmedian $35 · 10th to 90th $32 to $38
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 $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $41.69 | Professional | None | $32.36 | $38.02 | $41.69 |
Ambetter Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
BCBS Texas Setting Facility Modifier None Typical Low $31.62 Median $79.43 Typical High $147.91 | Facility | None | $31.62 | $79.43 | $147.91 |
BCBS Texas Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Christus Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $52.48 Typical High $112.20 | Facility | None | $35.48 | $52.48 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Moda Health Setting Facility Modifier None Typical Low $26.92 Median $38.02 Typical High $74.13 | Facility | None | $26.92 | $38.02 | $74.13 |
Moda Health Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $41.69 | Professional | None | $32.36 | $38.02 | $41.69 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $31.62 Median $39.81 Typical High $302.00 | Facility | None | $31.62 | $39.81 | $302.00 |
Providence Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
United Setting Professional Modifier None Typical Low $29.51 Median $36.31 Typical High $38.02 | Professional | None | $29.51 | $36.31 | $38.02 |
Wellpoint Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
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 $16.22 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $16.22 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $7.59 Typical High $7.59 | Professional | 53 · Discontinued | $6.46 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $4.79 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.24 | $3.80 | $3.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $18.62 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 53 · Discontinued | $7.59 | $7.59 | $7.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $5.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $3.80 |
Where Texas sits
The same service costs 97.7 times more in Arizona than in Rhode Island. 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· 12th of 51
$36.31
AZ $48.98RI $0.50
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.