How much rates vary
Facilitymedian $112 · 10th to 90th $26 to $3,311Professionalmedian $20 · 10th to 90th $14 to $85
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 $645.65 Median $2,398.83 Typical High $6,918.31 | Facility | None | $645.65 | $2,398.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $19.05 Typical High $5,370.32 | Professional | None | $14.45 | $19.05 | $5,370.32 |
BCBS Texas Setting Facility Modifier None Typical Low $47.86 Median $109.65 Typical High $204.17 | Facility | None | $47.86 | $109.65 | $204.17 |
BCBS Texas Setting Professional Modifier None Typical Low $19.50 Median $28.84 Typical High $64.57 | Professional | None | $19.50 | $28.84 | $64.57 |
Christus Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $40.74 Typical High $53.70 | Facility | None | $34.67 | $40.74 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $11.75 Median $19.05 Typical High $26.92 | Professional | None | $11.75 | $19.05 | $26.92 |
Moda Health Setting Facility Modifier None Typical Low $25.12 Median $1,995.26 Typical High $6,025.60 | Facility | None | $25.12 | $1,995.26 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $14.45 Median $17.78 Typical High $2,398.83 | Professional | None | $14.45 | $17.78 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $13.18 Median $13.80 Typical High $15.14 | Professional | None | $13.18 | $13.80 | $15.14 |
Oscar Health Setting Facility Modifier None Typical Low $12,589.25 Median $21,877.62 Typical High $21,877.62 | Facility | None | $12,589.25 | $21,877.62 | $21,877.62 |
Providence Setting Facility Modifier None Typical Low $17.38 Median $24.55 Typical High $40.74 | Facility | None | $17.38 | $24.55 | $40.74 |
Providence Setting Professional Modifier None Typical Low $11.75 Median $18.20 Typical High $26.92 | Professional | None | $11.75 | $18.20 | $26.92 |
United Setting Facility Modifier None Typical Low $70.79 Median $74.13 Typical High $97.72 | Facility | None | $70.79 | $74.13 | $97.72 |
United Setting Professional Modifier None Typical Low $15.49 Median $22.91 Typical High $33.88 | Professional | None | $15.49 | $22.91 | $33.88 |
Wellpoint Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
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 $7.24 Median $8.71 Typical High $11.22 | Professional | 52 · Reduced service | $7.24 | $8.71 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $3.47 Typical High $4.47 | Professional | 53 · Discontinued | $2.95 | $3.47 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $2.57 Typical High $3.39 | Professional | 55 · Aftercare only | $2.19 | $2.57 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.74 Typical High $2.24 | Professional | 56 · Pre-op care only | $1.45 | $1.74 | $2.24 |
Moda Health Setting Facility Modifier XU · Unusual separate service Typical Low $23.99 Median $134.90 Typical High $302.00 | Facility | XU · Unusual separate service | $23.99 | $134.90 | $302.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.24 Median $8.71 Typical High $10.47 | Professional | 52 · Reduced service | $7.24 | $8.71 | $10.47 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $3.47 Typical High $4.17 | Professional | 53 · Discontinued | $2.95 | $3.47 | $4.17 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $2.57 Typical High $3.16 | Professional | 55 · Aftercare only | $2.19 | $2.57 | $3.16 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.74 Typical High $2.09 | Professional | 56 · Pre-op care only | $1.45 | $1.74 | $2.09 |
Where Texas sits
The same service costs 40.7 times more in Tennessee than in New York. 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· 2nd of 51
$83.18
TN $676NY $16.60
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.