How much rates vary
Facilitymedian $28 · 10th to 90th $28 to $81Professionalmedian $34 · 10th to 90th $29 to $38
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 $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $33.88 Typical High $37.15 | Professional | None | $28.84 | $33.88 | $37.15 |
BCBS Texas Setting Facility Modifier None Typical Low $25.12 Median $53.70 Typical High $100.00 | Facility | None | $25.12 | $53.70 | $100.00 |
BCBS Texas Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Christus Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $47.86 Typical High $102.33 | Facility | None | $31.62 | $47.86 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Moda Health Setting Facility Modifier None Typical Low $32.36 Median $33.88 Typical High $48.98 | Facility | None | $32.36 | $33.88 | $48.98 |
Moda Health Setting Professional Modifier None Typical Low $28.84 Median $33.88 Typical High $39.81 | Professional | None | $28.84 | $33.88 | $39.81 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $30.20 | Professional | None | $28.84 | $28.84 | $30.20 |
Providence Setting Facility Modifier None Typical Low $31.62 Median $38.02 Typical High $275.42 | Facility | None | $31.62 | $38.02 | $275.42 |
Providence Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
United Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
United Setting Professional Modifier None Typical Low $30.90 Median $36.31 Typical High $38.02 | Professional | None | $30.90 | $36.31 | $38.02 |
Wellpoint Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
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 $14.45 Median $16.98 Typical High $16.98 | Professional | 52 · Reduced service | $14.45 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $6.76 Typical High $6.76 | Professional | 53 · Discontinued | $5.75 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $5.13 Typical High $5.13 | Professional | 55 · Aftercare only | $4.37 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.39 Typical High $3.39 | Professional | 56 · Pre-op care only | $2.88 | $3.39 | $3.39 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 52 · Reduced service | $16.98 | $16.98 | $16.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 53 · Discontinued | $6.76 | $6.76 | $6.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $5.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $3.39 |
Where Texas sits
The same service costs 1.6 times more in Arizona than in Georgia. 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· 28th of 51
$32.36
AZ $45.71GA $28.84
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.