How much rates vary
Facilitymedian $123 · 10th to 90th $102 to $135Professionalmedian $105 · 10th to 90th $91 to $138
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 $100.00 Median $104.71 Typical High $134.90 | Facility | None | $100.00 | $104.71 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $141.25 | Professional | None | $100.00 | $114.82 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $134.90 Typical High $134.90 | Professional | None | $109.65 | $134.90 | $134.90 |
BCBS Setting Professional Modifier None Typical Low $91.20 Median $102.33 Typical High $120.23 | Professional | None | $91.20 | $102.33 | $120.23 |
Christus Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $114.82 Typical High $177.83 | Professional | None | $77.62 | $114.82 | $177.83 |
Moda Health Setting Facility Modifier None Typical Low $81.28 Median $117.49 Typical High $162.18 | Facility | None | $81.28 | $117.49 | $162.18 |
Moda Health Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $141.25 | Professional | None | $100.00 | $114.82 | $141.25 |
Molina Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $102.33 | Professional | None | $87.10 | $97.72 | $102.33 |
Providence Setting Facility Modifier None Typical Low $81.28 Median $128.82 Typical High $199.53 | Facility | None | $81.28 | $128.82 | $199.53 |
Providence Setting Professional Modifier None Typical Low $77.62 Median $114.82 Typical High $169.82 | Professional | None | $77.62 | $114.82 | $169.82 |
United Setting Professional Modifier None Typical Low $97.72 Median $112.20 Typical High $173.78 | Professional | None | $97.72 | $112.20 | $173.78 |
Wellpoint Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
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 $50.12 Median $51.29 Typical High $52.48 | Facility | 52 · Reduced service | $50.12 | $51.29 | $52.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $14.79 Median $15.49 Typical High $15.85 | Facility | 55 · Aftercare only | $14.79 | $15.49 | $15.85 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.23 Typical High $10.47 | Facility | 56 · Pre-op care only | $10.00 | $10.23 | $10.47 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $134.90 Median $138.04 Typical High $141.25 | Facility | AF · Specialist physician | $134.90 | $138.04 | $141.25 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $100.00 Median $104.71 Typical High $104.71 | Facility | HO · Master's level | $100.00 | $104.71 | $104.71 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $114.82 Median $117.49 Typical High $120.23 | Facility | TD · Registered nurse | $114.82 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $51.29 Typical High $54.95 | Professional | 52 · Reduced service | $50.12 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $15.49 Typical High $16.60 | Professional | 55 · Aftercare only | $14.79 | $15.49 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.23 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.00 | $10.23 | $10.96 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $50.12 Median $51.29 Typical High $52.48 | Facility | 52 · Reduced service | $50.12 | $51.29 | $52.48 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $14.79 Median $15.49 Typical High $15.85 | Facility | 55 · Aftercare only | $14.79 | $15.49 | $15.85 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.23 Typical High $10.47 | Facility | 56 · Pre-op care only | $10.00 | $10.23 | $10.47 |
Moda Health Setting Facility Modifier AF · Specialist physician Typical Low $134.90 Median $138.04 Typical High $141.25 | Facility | AF · Specialist physician | $134.90 | $138.04 | $141.25 |
Moda Health Setting Facility Modifier HO · Master's level Typical Low $100.00 Median $104.71 Typical High $104.71 | Facility | HO · Master's level | $100.00 | $104.71 | $104.71 |
Moda Health Setting Facility Modifier TD · Registered nurse Typical Low $114.82 Median $117.49 Typical High $120.23 | Facility | TD · Registered nurse | $114.82 | $117.49 | $120.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $51.29 Typical High $57.54 | Professional | 52 · Reduced service | $50.12 | $51.29 | $57.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $15.49 Typical High $17.38 | Professional | 55 · Aftercare only | $14.79 | $15.49 | $17.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.23 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.00 | $10.23 | $11.48 |
Where Texas sits
The same service costs 2.1 times more in Wisconsin than in Ohio. 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· 35th of 51
$117
WI $209OH $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.