How much rates vary
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 $69.18 Median $70.79 Typical High $85.11 | Facility | None | $69.18 | $70.79 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $79.43 Typical High $87.10 | Professional | None | $67.61 | $79.43 | $87.10 |
BCBS Texas Setting Professional Modifier None Typical Low $74.13 Median $91.20 Typical High $162.18 | Professional | None | $74.13 | $91.20 | $162.18 |
Cigna 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 Professional Modifier None Typical Low $70.79 Median $91.20 Typical High $141.25 | Professional | None | $70.79 | $91.20 | $141.25 |
Lucent Health Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Moda Health Setting Facility Modifier None Typical Low $70.79 Median $102.33 Typical High $138.04 | Facility | None | $70.79 | $102.33 | $138.04 |
Moda Health Setting Professional Modifier None Typical Low $67.61 Median $79.43 Typical High $89.13 | Professional | None | $67.61 | $79.43 | $89.13 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $70.79 Typical High $100.00 | Professional | None | $67.61 | $70.79 | $100.00 |
Providence Setting Facility Modifier None Typical Low $70.79 Median $100.00 Typical High $138.04 | Facility | None | $70.79 | $100.00 | $138.04 |
Providence Setting Professional Modifier None Typical Low $69.18 Median $89.13 Typical High $141.25 | Professional | None | $69.18 | $89.13 | $141.25 |
United Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $138.04 | Professional | None | $72.44 | $95.50 | $138.04 |
Wellpoint Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
6 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 $33.88 Median $39.81 Typical High $44.67 | Professional | 52 · Reduced service | $33.88 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.02 Typical High $13.49 | Professional | 55 · Aftercare only | $10.23 | $12.02 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.94 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.76 | $7.94 | $8.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $39.81 Typical High $42.66 | Professional | 52 · Reduced service | $33.88 | $39.81 | $42.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.02 Typical High $12.59 | Professional | 55 · Aftercare only | $10.23 | $12.02 | $12.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.94 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.76 | $7.94 | $8.51 |
Where Texas sits
The same service costs 2.5 times more in Alaska than in Florida. 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· 41st of 51
$91.20
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.