How much rates vary
Facilitymedian $158 · 10th to 90th $45 to $316Professionalmedian $72 · 10th to 90th $17 to $170
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 $17.38 Median $36.31 Typical High $83.18 | Facility | None | $17.38 | $36.31 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $52.48 Typical High $95.50 | Professional | None | $17.38 | $52.48 | $95.50 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
BCBS Texas Setting Facility Modifier None Typical Low $72.44 Median $173.78 Typical High $316.23 | Facility | None | $72.44 | $173.78 | $316.23 |
BCBS Texas Setting Professional Modifier None Typical Low $26.30 Median $66.07 Typical High $112.20 | Professional | None | $26.30 | $66.07 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $30.20 Typical High $72.44 | Facility | None | $28.18 | $30.20 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $64.57 Typical High $112.20 | Professional | None | $23.99 | $64.57 | $112.20 |
Lucent Health Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $724.44 | Professional | None | $616.60 | $616.60 | $724.44 |
Moda Health Setting Facility Modifier None Typical Low $23.44 Median $39.81 Typical High $114.82 | Facility | None | $23.44 | $39.81 | $114.82 |
Moda Health Setting Professional Modifier None Typical Low $17.38 Median $52.48 Typical High $95.50 | Professional | None | $17.38 | $52.48 | $95.50 |
Molina Setting Professional Modifier None Typical Low $14.45 Median $79.43 Typical High $107.15 | Professional | None | $14.45 | $79.43 | $107.15 |
Oscar Health Setting Professional Modifier None Typical Low $26.92 Median $87.10 Typical High $309.03 | Professional | None | $26.92 | $87.10 | $309.03 |
Providence Setting Facility Modifier None Typical Low $23.44 Median $50.12 Typical High $120.23 | Facility | None | $23.44 | $50.12 | $120.23 |
Providence Setting Professional Modifier None Typical Low $22.91 Median $64.57 Typical High $112.20 | Professional | None | $22.91 | $64.57 | $112.20 |
United Setting Facility Modifier None Typical Low $109.65 Median $112.20 Typical High $151.36 | Facility | None | $109.65 | $112.20 | $151.36 |
United Setting Professional Modifier None Typical Low $23.99 Median $57.54 Typical High $117.49 | Professional | None | $23.99 | $57.54 | $117.49 |
Wellpoint Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
15 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 Facility Modifier 52 · Reduced service Typical Low $8.71 Median $17.38 Typical High $40.74 | Facility | 52 · Reduced service | $8.71 | $17.38 | $40.74 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.47 Median $7.08 Typical High $16.22 | Facility | 53 · Discontinued | $3.47 | $7.08 | $16.22 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.63 Median $5.25 Typical High $12.02 | Facility | 55 · Aftercare only | $2.63 | $5.25 | $12.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.74 Median $3.47 Typical High $8.13 | Facility | 56 · Pre-op care only | $1.74 | $3.47 | $8.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $26.30 Typical High $42.66 | Professional | 52 · Reduced service | $10.47 | $26.30 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $10.72 Typical High $16.98 | Professional | 53 · Discontinued | $4.17 | $10.72 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $7.94 Typical High $12.88 | Professional | 55 · Aftercare only | $3.09 | $7.94 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $5.25 Typical High $8.51 | Professional | 56 · Pre-op care only | $2.09 | $5.25 | $8.51 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $8.71 Median $15.85 Typical High $41.69 | Facility | 52 · Reduced service | $8.71 | $15.85 | $41.69 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $3.47 Median $6.46 Typical High $16.60 | Facility | 53 · Discontinued | $3.47 | $6.46 | $16.60 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $3.47 Median $5.25 Typical High $12.59 | Facility | 55 · Aftercare only | $3.47 | $5.25 | $12.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $8.71 Median $26.30 Typical High $42.66 | Professional | 52 · Reduced service | $8.71 | $26.30 | $42.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $10.72 Typical High $16.98 | Professional | 53 · Discontinued | $3.47 | $10.72 | $16.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $7.94 Typical High $12.88 | Professional | 55 · Aftercare only | $2.63 | $7.94 | $12.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $5.25 Typical High $8.51 | Professional | 56 · Pre-op care only | $1.74 | $5.25 | $8.51 |
Where Texas sits
The same service costs 3.6 times more in North Carolina than in Washington, DC. 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· 36th of 51
$74.13
NC $123DC $33.88
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.