How much rates vary
Facilitymedian $39 · 10th to 90th $25 to $110Professionalmedian $17 · 10th to 90th $9 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 $7.24 Median $7.24 Typical High $10.23 | Facility | None | $7.24 | $7.24 | $10.23 |
Aetna Setting Professional Modifier None Typical Low $7.24 Median $10.23 Typical High $16.98 | Professional | None | $7.24 | $10.23 | $16.98 |
BCBS Texas Setting Facility Modifier None Typical Low $25.70 Median $64.57 Typical High $125.89 | Facility | None | $25.70 | $64.57 | $125.89 |
BCBS Texas Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Christus Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Moda Health Setting Facility Modifier None Typical Low $8.71 Median $25.12 Typical High $91.20 | Facility | None | $8.71 | $25.12 | $91.20 |
Moda Health Setting Professional Modifier None Typical Low $7.24 Median $10.23 Typical High $33.11 | Professional | None | $7.24 | $10.23 | $33.11 |
Oscar Health Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $223.87 | Facility | None | $61.66 | $61.66 | $223.87 |
Providence Setting Facility Modifier None Typical Low $7.24 Median $10.23 Typical High $28.84 | Facility | None | $7.24 | $10.23 | $28.84 |
Providence Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
United Setting Facility Modifier None Typical Low $70.79 Median $74.13 Typical High $97.72 | Facility | None | $70.79 | $74.13 | $97.72 |
United Setting Professional Modifier None Typical Low $12.30 Median $23.99 Typical High $30.20 | Professional | None | $12.30 | $23.99 | $30.20 |
Wellpoint Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
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 $3.63 Median $5.01 Typical High $8.51 | Professional | 52 · Reduced service | $3.63 | $5.01 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $2.00 Typical High $3.39 | Professional | 53 · Discontinued | $1.45 | $2.00 | $3.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.51 Typical High $2.51 | Professional | 55 · Aftercare only | $1.07 | $1.51 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $1.00 Typical High $1.70 | Professional | 56 · Pre-op care only | $0.72 | $1.00 | $1.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.63 Median $5.01 Typical High $8.51 | Professional | 52 · Reduced service | $3.63 | $5.01 | $8.51 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $2.00 Typical High $3.39 | Professional | 53 · Discontinued | $1.45 | $2.00 | $3.39 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.51 Typical High $2.57 | Professional | 55 · Aftercare only | $1.07 | $1.51 | $2.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $1.00 Typical High $1.70 | Professional | 56 · Pre-op care only | $0.72 | $1.00 | $1.70 |
Where Texas sits
The same service costs 4.6 times more in Alabama than in Missouri. 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· 12th of 51
$34.67
AL $56.23MO $12.30
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.