How much rates vary
Facilitymedian $58 · 10th to 90th $35 to $145Professionalmedian $54 · 10th to 90th $37 to $58
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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $57.54 Typical High $63.10 | Professional | None | $51.29 | $57.54 | $63.10 |
Ambetter Setting Professional Modifier None Typical Low $23.99 Median $30.20 Typical High $30.20 | Professional | None | $23.99 | $30.20 | $30.20 |
BCBS Texas Setting Facility Modifier None Typical Low $34.67 Median $85.11 Typical High $158.49 | Facility | None | $34.67 | $85.11 | $158.49 |
BCBS Texas Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Christus Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $79.43 Typical High $169.82 | Facility | None | $53.70 | $79.43 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Moda Health Setting Facility Modifier None Typical Low $39.81 Median $57.54 Typical High $213.80 | Facility | None | $39.81 | $57.54 | $213.80 |
Moda Health Setting Professional Modifier None Typical Low $51.29 Median $57.54 Typical High $83.18 | Professional | None | $51.29 | $57.54 | $83.18 |
Molina Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Providence Setting Facility Modifier None Typical Low $38.02 Median $60.26 Typical High $457.09 | Facility | None | $38.02 | $60.26 | $457.09 |
Providence Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
United Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $57.54 | Professional | None | $43.65 | $54.95 | $57.54 |
Wellpoint Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
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 $25.70 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $25.70 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $10.23 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $7.59 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.13 | $5.75 | $5.75 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $28.84 | $28.84 | $28.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $11.48 | $11.48 | $11.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $8.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $5.75 |
Where Texas sits
The same service costs 1.5 times more in Colorado than in Alaska. 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· 15th of 51
$53.70
CO $58.88AK $38.90
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.