How much rates vary
Facilitymedian $25 · 10th to 90th $20 to $69Professionalmedian $21 · 10th to 90th $20 to $25
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 $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $21.88 Typical High $23.99 | Professional | None | $18.62 | $21.88 | $23.99 |
BCBS Texas Setting Facility Modifier None Typical Low $17.78 Median $43.65 Typical High $79.43 | Facility | None | $17.78 | $43.65 | $79.43 |
BCBS Texas Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Christus Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $20.42 Median $30.90 Typical High $66.07 | Facility | None | $20.42 | $30.90 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Moda Health Setting Facility Modifier None Typical Low $20.89 Median $31.62 Typical High $67.61 | Facility | None | $20.89 | $31.62 | $67.61 |
Moda Health Setting Professional Modifier None Typical Low $18.62 Median $21.88 Typical High $26.92 | Professional | None | $18.62 | $21.88 | $26.92 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $30.20 | Professional | None | $19.50 | $19.50 | $30.20 |
Oscar Health Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $50.12 | Facility | None | $25.12 | $25.12 | $50.12 |
Providence Setting Facility Modifier None Typical Low $20.42 Median $24.55 Typical High $177.83 | Facility | None | $20.42 | $24.55 | $177.83 |
Providence Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
United Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
United Setting Professional Modifier None Typical Low $19.95 Median $23.44 Typical High $24.55 | Professional | None | $19.95 | $23.44 | $24.55 |
Wellpoint Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
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 $9.33 Median $10.96 Typical High $10.96 | Professional | 52 · Reduced service | $9.33 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $4.37 Typical High $4.37 | Professional | 53 · Discontinued | $3.72 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $3.31 Typical High $3.31 | Professional | 55 · Aftercare only | $2.82 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.86 | $2.19 | $2.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | 52 · Reduced service | $10.96 | $10.96 | $10.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 53 · Discontinued | $4.37 | $4.37 | $4.37 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | 55 · Aftercare only | $3.31 | $3.31 | $3.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $2.19 | $2.19 | $2.19 |
Where Texas sits
The same service costs 2.1 times more in Alabama 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· 20th of 51
$21.88
AL $38.90RI $18.62
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.