How much rates vary
Facilitymedian $102 · 10th to 90th $102 to $398Professionalmedian $83 · 10th to 90th $68 to $110
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 $60.26 Median $60.26 Typical High $102.33 | Facility | None | $60.26 | $60.26 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $112.20 | Professional | None | $60.26 | $85.11 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $107.15 Typical High $107.15 | Professional | None | $93.33 | $107.15 | $107.15 |
BCBS Texas Setting Facility Modifier None Typical Low $141.25 Median $316.23 Typical High $549.54 | Facility | None | $141.25 | $316.23 | $549.54 |
BCBS Texas Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Christus Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Moda Health Setting Facility Modifier None Typical Low $39.81 Median $107.15 Typical High $147.91 | Facility | None | $39.81 | $107.15 | $147.91 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $117.49 | Professional | None | $60.26 | $85.11 | $117.49 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $70.79 Typical High $97.72 | Professional | None | $67.61 | $70.79 | $97.72 |
Providence Setting Facility Modifier None Typical Low $39.81 Median $107.15 Typical High $173.78 | Facility | None | $39.81 | $107.15 | $173.78 |
Providence Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
United Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $151.36 | Professional | None | $81.28 | $97.72 | $151.36 |
Wellpoint Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
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 $30.20 Median $38.02 Typical High $48.98 | Professional | 52 · Reduced service | $30.20 | $38.02 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $15.49 Typical High $19.50 | Professional | 53 · Discontinued | $12.02 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $11.48 Typical High $14.45 | Professional | 55 · Aftercare only | $8.91 | $11.48 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.76 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.03 | $7.76 | $9.77 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $38.02 Typical High $50.12 | Professional | 52 · Reduced service | $30.20 | $38.02 | $50.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $15.49 Typical High $19.95 | Professional | 53 · Discontinued | $12.02 | $15.49 | $19.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $11.48 Typical High $15.14 | Professional | 55 · Aftercare only | $8.91 | $11.48 | $15.14 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.76 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.03 | $7.76 | $10.00 |
Where Texas sits
The same service costs 3.0 times more in Alaska than in West Virginia. 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· 48th of 51
$102
AK $288WV $97.72
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.