How much rates vary
Facilitymedian $81 · 10th to 90th $66 to $83Professionalmedian $69 · 10th to 90th $58 to $91
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 $64.57 Median $67.61 Typical High $87.10 | Facility | None | $64.57 | $67.61 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $74.13 Typical High $91.20 | Professional | None | $64.57 | $74.13 | $91.20 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $79.43 Typical High $79.43 | Professional | None | $77.62 | $79.43 | $79.43 |
BCBS Texas Setting Professional Modifier None Typical Low $54.95 Median $61.66 Typical High $69.18 | Professional | None | $54.95 | $61.66 | $69.18 |
Christus Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $67.61 | Facility | None | $66.07 | $66.07 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $69.18 Typical High $114.82 | Professional | None | $46.77 | $69.18 | $114.82 |
Moda Health Setting Facility Modifier None Typical Low $56.23 Median $75.86 Typical High $104.71 | Facility | None | $56.23 | $75.86 | $104.71 |
Moda Health Setting Professional Modifier None Typical Low $64.57 Median $74.13 Typical High $91.20 | Professional | None | $64.57 | $74.13 | $91.20 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $67.61 Typical High $102.33 | Professional | None | $57.54 | $67.61 | $102.33 |
Providence Setting Facility Modifier None Typical Low $56.23 Median $77.62 Typical High $131.83 | Facility | None | $56.23 | $77.62 | $131.83 |
Providence Setting Professional Modifier None Typical Low $46.77 Median $69.18 Typical High $104.71 | Professional | None | $46.77 | $69.18 | $104.71 |
United Setting Professional Modifier None Typical Low $61.66 Median $75.86 Typical High $114.82 | Professional | None | $61.66 | $75.86 | $114.82 |
Wellpoint Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
18 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 $32.36 Median $33.11 Typical High $33.88 | Facility | 52 · Reduced service | $32.36 | $33.11 | $33.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.77 Median $10.00 Typical High $10.23 | Facility | 55 · Aftercare only | $9.77 | $10.00 | $10.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.76 Typical High $6.76 | Facility | 56 · Pre-op care only | $6.46 | $6.76 | $6.76 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $87.10 Median $91.20 Typical High $91.20 | Facility | AF · Specialist physician | $87.10 | $91.20 | $91.20 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $66.07 Median $67.61 Typical High $69.18 | Facility | HO · Master's level | $66.07 | $67.61 | $69.18 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $74.13 Median $77.62 Typical High $77.62 | Facility | TD · Registered nurse | $74.13 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $33.11 Typical High $33.88 | Professional | 52 · Reduced service | $32.36 | $33.11 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.00 Typical High $10.23 | Professional | 55 · Aftercare only | $9.77 | $10.00 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.46 | $6.76 | $6.76 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $32.36 Median $33.11 Typical High $33.88 | Facility | 52 · Reduced service | $32.36 | $33.11 | $33.88 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $9.77 Median $10.00 Typical High $10.23 | Facility | 55 · Aftercare only | $9.77 | $10.00 | $10.23 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.76 Typical High $6.76 | Facility | 56 · Pre-op care only | $6.46 | $6.76 | $6.76 |
Moda Health Setting Facility Modifier AF · Specialist physician Typical Low $87.10 Median $91.20 Typical High $91.20 | Facility | AF · Specialist physician | $87.10 | $91.20 | $91.20 |
Moda Health Setting Facility Modifier HO · Master's level Typical Low $66.07 Median $67.61 Typical High $69.18 | Facility | HO · Master's level | $66.07 | $67.61 | $69.18 |
Moda Health Setting Facility Modifier TD · Registered nurse Typical Low $74.13 Median $77.62 Typical High $77.62 | Facility | TD · Registered nurse | $74.13 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $33.11 Typical High $38.02 | Professional | 52 · Reduced service | $32.36 | $33.11 | $38.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.00 Typical High $11.22 | Professional | 55 · Aftercare only | $9.77 | $10.00 | $11.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.76 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.46 | $6.76 | $7.59 |
Where Texas sits
The same service costs 2.1 times more in Oregon than in Alabama. 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· 32nd of 51
$77.62
OR $135AL $63.10
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.