How much rates vary
Facilitymedian $135 · 10th to 90th $46 to $245Professionalmedian $132 · 10th to 90th $120 to $141
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 $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $141.25 | Professional | None | $120.23 | $141.25 | $141.25 |
BCBS Texas Setting Facility Modifier None Typical Low $42.66 Median $112.20 Typical High $190.55 | Facility | None | $42.66 | $112.20 | $190.55 |
BCBS Texas Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $208.93 Typical High $436.52 | Facility | None | $138.04 | $208.93 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Moda Health Setting Facility Modifier None Typical Low $38.02 Median $141.25 Typical High $199.53 | Facility | None | $38.02 | $141.25 | $199.53 |
Moda Health Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $141.25 | Professional | None | $120.23 | $141.25 | $141.25 |
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 $85.11 Median $154.88 Typical High $1,174.90 | Facility | None | $85.11 | $154.88 | $1,174.90 |
Providence Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
United Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $141.25 | Professional | None | $112.20 | $138.04 | $141.25 |
Wellpoint Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
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 $60.26 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $60.26 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $23.99 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $17.78 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.02 | $14.13 | $14.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $70.79 | $70.79 | $70.79 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $28.18 | $28.18 | $28.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $20.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $14.13 |
Where Texas sits
The same service costs 5.1 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· 18th of 51
$135
AZ $204AL $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.