How much rates vary
Facilitymedian $43 · 10th to 90th $30 to $120Professionalmedian $35 · 10th to 90th $32 to $37
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 $36.31 Median $36.31 Typical High $50.12 | Facility | None | $36.31 | $36.31 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $36.31 Typical High $39.81 | Professional | None | $32.36 | $36.31 | $39.81 |
Ambetter Setting Professional Modifier None Typical Low $13.18 Median $28.84 Typical High $75.86 | Professional | None | $13.18 | $28.84 | $75.86 |
BCBS Texas Setting Facility Modifier None Typical Low $30.20 Median $74.13 Typical High $141.25 | Facility | None | $30.20 | $74.13 | $141.25 |
BCBS Texas Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Christus Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $51.29 Typical High $109.65 | Facility | None | $34.67 | $51.29 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Moda Health Setting Facility Modifier None Typical Low $20.42 Median $42.66 Typical High $208.93 | Facility | None | $20.42 | $42.66 | $208.93 |
Moda Health Setting Professional Modifier None Typical Low $32.36 Median $36.31 Typical High $52.48 | Professional | None | $32.36 | $36.31 | $52.48 |
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 $28.84 Median $38.90 Typical High $295.12 | Facility | None | $28.84 | $38.90 | $295.12 |
Providence Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
United Setting Professional Modifier None Typical Low $29.51 Median $36.31 Typical High $37.15 | Professional | None | $29.51 | $36.31 | $37.15 |
Wellpoint Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
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 $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $16.22 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $6.46 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $4.90 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.24 | $3.63 | $3.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $18.20 | $18.20 | $18.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $7.24 | $7.24 | $7.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $5.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.63 |
Where Texas sits
The same service costs 5.4 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· 6th of 51
$36.31
AZ $45.71RI $8.51
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.