How much rates vary
Facilitymedian $120 · 10th to 90th $120 to $120Professionalmedian $107 · 10th to 90th $17 to $200
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 $93.33 Median $112.20 Typical High $120.23 | Facility | None | $93.33 | $112.20 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $169.82 | Professional | None | $93.33 | $114.82 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
BCBS Texas Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $199.53 | Professional | None | $104.71 | $141.25 | $199.53 |
Christus Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $407.38 | Facility | None | $109.65 | $109.65 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $177.83 | Professional | None | $97.72 | $125.89 | $177.83 |
Lucent Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $125.89 Typical High $223.87 | Facility | None | $104.71 | $125.89 | $223.87 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $169.82 | Professional | None | $93.33 | $114.82 | $169.82 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $81.28 Typical High $109.65 | Professional | None | $14.79 | $81.28 | $109.65 |
Oscar Health Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $169.82 | Professional | None | $162.18 | $162.18 | $169.82 |
Providence Setting Facility Modifier None Typical Low $104.71 Median $141.25 Typical High $208.93 | Facility | None | $104.71 | $141.25 | $208.93 |
Providence Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $173.78 | Professional | None | $97.72 | $125.89 | $173.78 |
United Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $186.21 | Professional | None | $95.50 | $123.03 | $186.21 |
Wellpoint Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
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 $46.77 Median $56.23 Typical High $72.44 | Professional | 52 · Reduced service | $46.77 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $22.39 Typical High $29.51 | Professional | 53 · Discontinued | $18.62 | $22.39 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.98 Typical High $21.88 | Professional | 55 · Aftercare only | $13.80 | $16.98 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $11.22 Typical High $14.45 | Professional | 56 · Pre-op care only | $9.33 | $11.22 | $14.45 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $56.23 Typical High $72.44 | Professional | 52 · Reduced service | $46.77 | $56.23 | $72.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $22.39 Typical High $29.51 | Professional | 53 · Discontinued | $18.62 | $22.39 | $29.51 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.98 Typical High $21.88 | Professional | 55 · Aftercare only | $13.80 | $16.98 | $21.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $11.22 Typical High $14.45 | Professional | 56 · Pre-op care only | $9.33 | $11.22 | $14.45 |
Where Texas sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 49th of 51
$107
AK $316UT $97.72
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.