How much rates vary
Facilitymedian $51 · 10th to 90th $40 to $126Professionalmedian $42 · 10th to 90th $30 to $501
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 $42.66 Median $42.66 Typical High $46.77 | Facility | None | $42.66 | $42.66 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $43.65 Typical High $53.70 | Professional | None | $37.15 | $43.65 | $53.70 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
BCBS Texas Setting Facility Modifier None Typical Low $52.48 Median $74.13 Typical High $186.21 | Facility | None | $52.48 | $74.13 | $186.21 |
BCBS Texas Setting Professional Modifier None Typical Low $31.62 Median $35.48 Typical High $35.48 | Professional | None | $31.62 | $35.48 | $35.48 |
Christus Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $48.98 | Facility | None | $39.81 | $39.81 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | None | $33.88 | $33.88 | $39.81 |
Lucent Health Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $501.19 | Professional | None | $331.13 | $501.19 | $501.19 |
Moda Health Setting Facility Modifier None Typical Low $18.20 Median $43.65 Typical High $67.61 | Facility | None | $18.20 | $43.65 | $67.61 |
Moda Health Setting Professional Modifier None Typical Low $37.15 Median $43.65 Typical High $57.54 | Professional | None | $37.15 | $43.65 | $57.54 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $81.28 | Professional | None | $44.67 | $52.48 | $81.28 |
Providence Setting Facility Modifier None Typical Low $28.18 Median $39.81 Typical High $67.61 | Facility | None | $28.18 | $39.81 | $67.61 |
Providence Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | None | $33.88 | $33.88 | $39.81 |
United Setting Professional Modifier None Typical Low $19.95 Median $30.20 Typical High $39.81 | Professional | None | $19.95 | $30.20 | $39.81 |
Wellpoint Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
9 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 $19.95 Median $21.38 Typical High $26.92 | Professional | 52 · Reduced service | $19.95 | $21.38 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.71 Typical High $10.72 | Professional | 53 · Discontinued | $7.94 | $8.71 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.46 Typical High $7.94 | Professional | 55 · Aftercare only | $6.03 | $6.46 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.98 | $4.37 | $5.37 |
Ambetter Setting Professional Modifier U1 · State-defined Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | U1 · State-defined | $46.77 | $46.77 | $46.77 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $21.38 Typical High $26.92 | Professional | 52 · Reduced service | $19.95 | $21.38 | $26.92 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.71 Typical High $10.72 | Professional | 53 · Discontinued | $7.94 | $8.71 | $10.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.46 Typical High $7.94 | Professional | 55 · Aftercare only | $6.03 | $6.46 | $7.94 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.98 | $4.37 | $5.37 |
Where Texas sits
The same service costs 2.3 times more in Kansas than in New Jersey. 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· 25th of 51
$43.65
KS $79.43NJ $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.