How much rates vary
Facilitymedian $98 · 10th to 90th $37 to $200Professionalmedian $74 · 10th to 90th $66 to $79
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 $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $79.43 Typical High $79.43 | Professional | None | $74.13 | $79.43 | $79.43 |
BCBS Texas Setting Facility Modifier None Typical Low $37.15 Median $100.00 Typical High $190.55 | Facility | None | $37.15 | $100.00 | $190.55 |
BCBS Texas Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $112.20 Typical High $234.42 | Facility | None | $74.13 | $112.20 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Moda Health Setting Facility Modifier None Typical Low $25.12 Median $79.43 Typical High $112.20 | Facility | None | $25.12 | $79.43 | $112.20 |
Moda Health Setting Professional Modifier None Typical Low $67.61 Median $79.43 Typical High $79.43 | Professional | None | $67.61 | $79.43 | $79.43 |
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 $61.66 Median $83.18 Typical High $630.96 | Facility | None | $61.66 | $83.18 | $630.96 |
Providence Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
United Setting Professional Modifier None Typical Low $63.10 Median $77.62 Typical High $79.43 | Professional | None | $63.10 | $77.62 | $79.43 |
Wellpoint Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
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 $33.88 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $33.88 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $13.49 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $10.00 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.76 | $7.94 | $7.94 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $39.81 | $39.81 | $39.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $15.85 | $15.85 | $15.85 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $11.75 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $7.94 |
Where Texas sits
The same service costs 6.5 times more in Arizona than in Hawaii. 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· 3rd of 51
$79.43
AZ $115HI $17.78
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.