How much rates vary
Facilitymedian $112 · 10th to 90th $83 to $166Professionalmedian $100 · 10th to 90th $17 to $692
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 $83.18 Median $100.00 Typical High $107.15 | Facility | None | $83.18 | $100.00 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $100.00 Typical High $117.49 | Professional | None | $83.18 | $100.00 | $117.49 |
BCBS Texas Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $190.55 | Professional | None | $95.50 | $125.89 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $177.83 | Professional | None | $85.11 | $112.20 | $177.83 |
Lucent Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $891.25 | Professional | None | $691.83 | $691.83 | $891.25 |
Moda Health Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $165.96 | Facility | None | $83.18 | $114.82 | $165.96 |
Moda Health Setting Professional Modifier None Typical Low $83.18 Median $100.00 Typical High $123.03 | Professional | None | $83.18 | $100.00 | $123.03 |
Molina Setting Professional Modifier None Typical Low $15.14 Median $85.11 Typical High $109.65 | Professional | None | $15.14 | $85.11 | $109.65 |
Oscar Health Setting Professional Modifier None Typical Low $109.65 Median $199.53 Typical High $245.47 | Professional | None | $109.65 | $199.53 | $245.47 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $125.89 Typical High $173.78 | Facility | None | $100.00 | $125.89 | $173.78 |
Providence Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $181.97 | Professional | None | $85.11 | $112.20 | $181.97 |
United Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $177.83 | Professional | None | $89.13 | $117.49 | $177.83 |
Wellpoint Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
9 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 $41.69 Median $50.12 Typical High $60.26 | Professional | 52 · Reduced service | $41.69 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $19.95 Typical High $23.99 | Professional | 53 · Discontinued | $16.60 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $15.14 Typical High $17.78 | Professional | 55 · Aftercare only | $12.30 | $15.14 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.00 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.32 | $10.00 | $12.02 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 59 · Distinct service | $134.90 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $50.12 Typical High $58.88 | Professional | 52 · Reduced service | $41.69 | $50.12 | $58.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $19.95 Typical High $23.44 | Professional | 53 · Discontinued | $16.60 | $19.95 | $23.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $15.14 Typical High $17.78 | Professional | 55 · Aftercare only | $12.30 | $15.14 | $17.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.00 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.32 | $10.00 | $11.75 |
Where Texas sits
The same service costs 2.8 times more in Alaska than in Texas. 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· 51st of 51
$100
AK $282TX $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.