How much rates vary
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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $77.62 | Professional | None | $66.07 | $77.62 | $77.62 |
BCBS Texas Setting Facility Modifier None Typical Low $151.36 Median $354.81 Typical High $616.60 | Facility | None | $151.36 | $354.81 | $616.60 |
BCBS Texas Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $169.82 Typical High $229.09 | Facility | None | $72.44 | $169.82 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Moda Health Setting Facility Modifier None Typical Low $74.13 Median $77.62 Typical High $112.20 | Facility | None | $74.13 | $77.62 | $112.20 |
Moda Health Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $77.62 | Professional | None | $66.07 | $77.62 | $77.62 |
Providence Setting Facility Modifier None Typical Low $72.44 Median $109.65 Typical High $616.60 | Facility | None | $72.44 | $109.65 | $616.60 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $87.10 | Professional | None | $70.79 | $83.18 | $87.10 |
Wellpoint Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
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 $33.11 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $33.11 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $13.18 | $15.49 | $15.49 |
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 $6.61 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.61 | $7.76 | $7.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $38.90 | $38.90 | $38.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $15.49 | $15.49 | $15.49 |
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 $7.76 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $7.76 |
Where Texas sits
The same service costs 2.8 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
$87.10
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.