How much rates vary
Facilitymedian $288 · 10th to 90th $27 to $4,169Professionalmedian $62 · 10th to 90th $11 to $537
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 $69.18 Median $3,715.35 Typical High $9,120.11 | Facility | None | $69.18 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $58.88 Typical High $77.62 | Professional | None | $15.49 | $58.88 | $77.62 |
Ambetter Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
BCBS Texas Setting Facility Modifier None Typical Low $162.18 Median $323.59 Typical High $1,380.38 | Facility | None | $162.18 | $323.59 | $1,380.38 |
BCBS Texas Setting Professional Modifier None Typical Low $18.20 Median $70.79 Typical High $85.11 | Professional | None | $18.20 | $70.79 | $85.11 |
Christus Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Lucent Health Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $691.83 | Professional | None | $537.03 | $691.83 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $19.05 Median $77.62 Typical High $4,168.69 | Facility | None | $19.05 | $77.62 | $4,168.69 |
Moda Health Setting Professional Modifier None Typical Low $15.49 Median $58.88 Typical High $77.62 | Professional | None | $15.49 | $58.88 | $77.62 |
Molina Setting Professional Modifier None Typical Low $9.55 Median $52.48 Typical High $72.44 | Professional | None | $9.55 | $52.48 | $72.44 |
Oscar Health Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $20.89 | Professional | None | $19.95 | $19.95 | $20.89 |
Providence Setting Facility Modifier None Typical Low $19.05 Median $39.81 Typical High $89.13 | Facility | None | $19.05 | $39.81 | $89.13 |
Providence Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
United Setting Facility Modifier None Typical Low $302.00 Median $316.23 Typical High $416.87 | Facility | None | $302.00 | $316.23 | $416.87 |
United Setting Professional Modifier None Typical Low $18.62 Median $40.74 Typical High $87.10 | Professional | None | $18.62 | $40.74 | $87.10 |
Wellpoint Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
10 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 $7.76 Median $29.51 Typical High $38.02 | Professional | 52 · Reduced service | $7.76 | $29.51 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $11.75 Typical High $15.14 | Professional | 53 · Discontinued | $3.09 | $11.75 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $8.91 Typical High $11.48 | Professional | 55 · Aftercare only | $2.34 | $8.91 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $5.89 Typical High $7.59 | Professional | 56 · Pre-op care only | $1.55 | $5.89 | $7.59 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $38.90 Median $38.90 Typical High $50.12 | Professional | 59 · Distinct service | $38.90 | $38.90 | $50.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.76 Median $29.51 Typical High $37.15 | Professional | 52 · Reduced service | $7.76 | $29.51 | $37.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $11.75 Typical High $14.79 | Professional | 53 · Discontinued | $3.09 | $11.75 | $14.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $8.91 Typical High $11.22 | Professional | 55 · Aftercare only | $2.34 | $8.91 | $11.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $5.89 Typical High $7.41 | Professional | 56 · Pre-op care only | $1.55 | $5.89 | $7.41 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 59 · Distinct service | $162.18 | $162.18 | $162.18 |
Where Texas sits
The same service costs 6.5 times more in Alaska than in Indiana. 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· 27th of 51
$63.10
AK $138IN $21.38
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.