How much rates vary
Facilitymedian $25 · 10th to 90th $25 to $95Professionalmedian $30 · 10th to 90th $25 to $30
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 $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier None (both parts) Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None (both parts) | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 52 · Reduced service | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $2.51 |
BCBS Texas Setting Facility Modifier None Typical Low $79.43 Median $91.20 Typical High $95.50 | Facility | None | $79.43 | $91.20 | $95.50 |
Cigna Setting Professional Modifier None (both parts) Typical Low $95.50 Median $95.50 Typical High $120.23 | Professional | None (both parts) | $95.50 | $95.50 | $120.23 |
Health Smart Setting Professional Modifier None (both parts) Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None (both parts) | $25.12 | $25.12 | $25.12 |
Moda Health Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $1,000.00 | Facility | None | $25.12 | $25.12 | $1,000.00 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None (both parts) | $25.12 | $25.12 | $25.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 52 · Reduced service | $12.59 | $12.59 | $12.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $5.01 | $5.01 | $5.01 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $2.51 |
Molina Setting Professional Modifier None (both parts) Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None (both parts) | $30.20 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $69.18 | Facility | None | $25.12 | $25.12 | $69.18 |
Providence Setting Professional Modifier None (both parts) Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None (both parts) | $25.12 | $25.12 | $25.12 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None (both parts) | $186.21 | $186.21 | $186.21 |
2 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 |
|---|---|---|---|---|---|
Cigna Setting Professional Modifier 26 · Professional part Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 26 · Professional part | $5.01 | $5.01 | $5.01 |
Providence Setting Professional Modifier 26 · Professional part Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 26 · Professional part | $5.01 | $5.01 | $5.01 |
Where Texas sits
The same service costs 100.0 times more in Massachusetts than in Maryland. 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· 18th of 50
$30.20
MA $2,512MD $25.12
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.