How much rates vary
Facilitymedian $115 · 10th to 90th $47 to $251Professionalmedian $83 · 10th to 90th $47 to $631
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 $77.62 Median $77.62 Typical High $87.10 | Facility | None | $77.62 | $77.62 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $77.62 Typical High $87.10 | Professional | None | $67.61 | $77.62 | $87.10 |
BCBS Texas Setting Facility Modifier None Typical Low $46.77 Median $123.03 Typical High $234.42 | Facility | None | $46.77 | $123.03 | $234.42 |
BCBS Texas Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $194.98 Typical High $263.03 | Facility | None | $83.18 | $194.98 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Lucent Health Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $851.14 | Professional | None | $630.96 | $630.96 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $24.55 Median $41.69 Typical High $295.12 | Facility | None | $24.55 | $41.69 | $295.12 |
Moda Health Setting Professional Modifier None Typical Low $67.61 Median $77.62 Typical High $87.10 | Professional | None | $67.61 | $77.62 | $87.10 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $44.67 | Professional | None | $30.20 | $30.20 | $44.67 |
Providence Setting Facility Modifier None Typical Low $83.18 Median $114.82 Typical High $707.95 | Facility | None | $83.18 | $114.82 | $707.95 |
Providence Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
United Setting Professional Modifier None Typical Low $24.55 Median $52.48 Typical High $112.20 | Professional | None | $24.55 | $52.48 | $112.20 |
Wellpoint Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
8 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 $38.90 Typical High $43.65 | Professional | 52 · Reduced service | $33.88 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $15.49 Typical High $17.38 | Professional | 53 · Discontinued | $13.49 | $15.49 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.75 Typical High $12.88 | Professional | 55 · Aftercare only | $10.23 | $11.75 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.76 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.76 | $7.76 | $8.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $38.90 Typical High $41.69 | Professional | 52 · Reduced service | $33.88 | $38.90 | $41.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $15.49 Typical High $16.60 | Professional | 53 · Discontinued | $13.49 | $15.49 | $16.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.75 Typical High $12.30 | Professional | 55 · Aftercare only | $10.23 | $11.75 | $12.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.76 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.76 | $7.76 | $8.32 |
Where Texas sits
The same service costs 5.0 times more in Ohio than in Hawaii. 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
$83.18
OH $282HI $56.23
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.