How much rates vary
Facilitymedian $162 · 10th to 90th $76 to $1,905Professionalmedian $170 · 10th to 90th $41 to $1,230
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 $177.83 Median $3,715.35 Typical High $9,120.11 | Facility | None | $177.83 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $151.36 Typical High $229.09 | Professional | None | $54.95 | $151.36 | $229.09 |
BCBS Texas Setting Facility Modifier None Typical Low $74.13 Median $186.21 Typical High $371.54 | Facility | None | $74.13 | $186.21 | $371.54 |
BCBS Texas Setting Professional Modifier None Typical Low $53.70 Median $144.54 Typical High $162.18 | Professional | None | $53.70 | $144.54 | $162.18 |
Christus Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $151.36 | Facility | None | $67.61 | $67.61 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $154.88 Typical High $269.15 | Professional | None | $66.07 | $154.88 | $269.15 |
Lucent Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,230.27 | $1,698.24 |
Moda Health Setting Facility Modifier None Typical Low $69.18 Median $1,230.27 Typical High $6,025.60 | Facility | None | $69.18 | $1,230.27 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $54.95 Median $151.36 Typical High $229.09 | Professional | None | $54.95 | $151.36 | $229.09 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $169.82 Typical High $218.78 | Professional | None | $29.51 | $169.82 | $218.78 |
Oscar Health Setting Professional Modifier None Typical Low $194.98 Median $204.17 Typical High $741.31 | Professional | None | $194.98 | $204.17 | $741.31 |
Providence Setting Facility Modifier None Typical Low $60.26 Median $104.71 Typical High $251.19 | Facility | None | $60.26 | $104.71 | $251.19 |
Providence Setting Professional Modifier None Typical Low $66.07 Median $162.18 Typical High $269.15 | Professional | None | $66.07 | $162.18 | $269.15 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $58.88 | Facility | None | $43.65 | $43.65 | $58.88 |
United Setting Professional Modifier None Typical Low $58.88 Median $141.25 Typical High $245.47 | Professional | None | $58.88 | $141.25 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
11 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 $26.92 Median $72.44 Typical High $100.00 | Professional | 52 · Reduced service | $26.92 | $72.44 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $28.84 Typical High $39.81 | Professional | 53 · Discontinued | $10.72 | $28.84 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $107.15 Typical High $151.36 | Professional | 54 · Surgery only | $40.74 | $107.15 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $21.88 Typical High $30.20 | Professional | 55 · Aftercare only | $8.13 | $21.88 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $14.45 Typical High $19.95 | Professional | 56 · Pre-op care only | $5.37 | $14.45 | $19.95 |
Ambetter Setting Professional Modifier GN · Speech therapy plan Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | GN · Speech therapy plan | $64.57 | $64.57 | $64.57 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $74.13 Typical High $100.00 | Professional | 52 · Reduced service | $25.12 | $74.13 | $100.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $30.20 Typical High $39.81 | Professional | 53 · Discontinued | $10.00 | $30.20 | $39.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $112.20 Typical High $151.36 | Professional | 54 · Surgery only | $38.02 | $112.20 | $151.36 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $22.39 Typical High $30.20 | Professional | 55 · Aftercare only | $7.59 | $22.39 | $30.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $14.79 Typical High $19.95 | Professional | 56 · Pre-op care only | $5.01 | $14.79 | $19.95 |
Where Texas sits
The same service costs 2.9 times more in Washington than in Kentucky. 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· 27th of 51
$170
WA $288KY $100
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.