How much rates vary
Facilitymedian $155 · 10th to 90th $62 to $295Professionalmedian $85 · 10th to 90th $72 to $87
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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $87.10 | Professional | None | $75.86 | $87.10 | $87.10 |
BCBS Texas Setting Facility Modifier None Typical Low $61.66 Median $158.49 Typical High $295.12 | Facility | None | $61.66 | $158.49 | $295.12 |
BCBS Texas Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $120.23 Typical High $257.04 | Facility | None | $81.28 | $120.23 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Moda Health Setting Facility Modifier None Typical Low $29.51 Median $87.10 Typical High $123.03 | Facility | None | $29.51 | $87.10 | $123.03 |
Moda Health Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $87.10 | Professional | None | $75.86 | $87.10 | $87.10 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Providence Setting Facility Modifier None Typical Low $72.44 Median $91.20 Typical High $691.83 | Facility | None | $72.44 | $91.20 | $691.83 |
Providence Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
United Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
United Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $87.10 | Professional | None | $69.18 | $85.11 | $87.10 |
Wellpoint Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
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 $37.15 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $37.15 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $15.14 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $11.22 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.59 | $8.71 | $8.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $43.65 | $43.65 | $43.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $17.38 | $17.38 | $17.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $12.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $8.71 |
Where Texas sits
The same service costs 3.0 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· 3rd of 51
$91.20
AZ $117AL $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.