How much rates vary
Facilitymedian $93 · 10th to 90th $47 to $229Professionalmedian $56 · 10th to 90th $44 to $60
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 $58.88 Median $60.26 Typical High $72.44 | Facility | None | $58.88 | $60.26 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $60.26 Typical High $66.07 | Professional | None | $47.86 | $60.26 | $66.07 |
Ambetter Setting Professional Modifier None Typical Low $31.62 Median $35.48 Typical High $39.81 | Professional | None | $31.62 | $35.48 | $39.81 |
BCBS Texas Setting Facility Modifier None Typical Low $41.69 Median $102.33 Typical High $199.53 | Facility | None | $41.69 | $102.33 | $199.53 |
BCBS Texas Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Baylor Scott & White Setting Facility Modifier None Typical Low $34.67 Median $39.81 Typical High $199.53 | Facility | None | $34.67 | $39.81 | $199.53 |
Christus Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $79.43 Typical High $177.83 | Facility | None | $47.86 | $79.43 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Health Smart Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $60.26 | Professional | None | $51.29 | $51.29 | $60.26 |
Lucent Health Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $60.26 | Professional | None | $51.29 | $51.29 | $60.26 |
Moda Health Setting Facility Modifier None Typical Low $63.10 Median $123.03 Typical High $323.59 | Facility | None | $63.10 | $123.03 | $323.59 |
Moda Health Setting Professional Modifier None Typical Low $39.81 Median $60.26 Typical High $75.86 | Professional | None | $39.81 | $60.26 | $75.86 |
Molina Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Oscar Health Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $457.09 | Facility | None | $371.54 | $371.54 | $457.09 |
Providence Setting Facility Modifier None Typical Low $45.71 Median $63.10 Typical High $478.63 | Facility | None | $45.71 | $63.10 | $478.63 |
Providence Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $46.77 Median $58.88 Typical High $58.88 | Professional | None | $46.77 | $58.88 | $58.88 |
Wellpoint Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
6 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 55 · Aftercare only Typical Low $6.03 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $6.03 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.07 | $6.03 | $6.03 |
Moda Health Setting Facility Modifier 59 · Distinct service Typical Low $120.23 Median $123.03 Typical High $123.03 | Facility | 59 · Distinct service | $120.23 | $123.03 | $123.03 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $83.18 Median $87.10 Typical High $186.21 | Facility | JZ · No drug discarded | $83.18 | $87.10 | $186.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $8.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.03 |
Where Texas sits
The same service costs 2.0 times more in Minnesota 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· 3rd of 51
$61.66
MN $81.28AL $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.