How much rates vary
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 $43.65 Median $45.71 Typical High $45.71 | Facility | None | $43.65 | $45.71 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $44.67 Typical High $47.86 | Professional | None | $43.65 | $44.67 | $47.86 |
BCBS Texas Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $194.98 | Professional | None | $46.77 | $46.77 | $194.98 |
Christus Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Lucent Health Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $457.09 | Professional | None | $338.84 | $457.09 | $457.09 |
Moda Health Setting Facility Modifier None Typical Low $45.71 Median $54.95 Typical High $63.10 | Facility | None | $45.71 | $54.95 | $63.10 |
Moda Health Setting Professional Modifier None Typical Low $43.65 Median $44.67 Typical High $47.86 | Professional | None | $43.65 | $44.67 | $47.86 |
Molina Setting Professional Modifier None Typical Low $10.00 Median $54.95 Typical High $74.13 | Professional | None | $10.00 | $54.95 | $74.13 |
Providence Setting Facility Modifier None Typical Low $45.71 Median $57.54 Typical High $66.07 | Facility | None | $45.71 | $57.54 | $66.07 |
Providence Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier None Typical Low $43.65 Median $56.23 Typical High $77.62 | Professional | None | $43.65 | $56.23 | $77.62 |
Wellpoint Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
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 $21.88 Median $22.39 Typical High $23.99 | Professional | 52 · Reduced service | $21.88 | $22.39 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.91 Typical High $9.55 | Professional | 53 · Discontinued | $8.71 | $8.91 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.61 Typical High $7.08 | Professional | 55 · Aftercare only | $6.46 | $6.61 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.47 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.37 | $4.47 | $4.79 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $22.39 Typical High $22.91 | Professional | 52 · Reduced service | $21.88 | $22.39 | $22.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.91 Typical High $9.12 | Professional | 53 · Discontinued | $8.71 | $8.91 | $9.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.61 Typical High $6.92 | Professional | 55 · Aftercare only | $6.46 | $6.61 | $6.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.47 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.37 | $4.47 | $4.57 |
Where Texas sits
The same service costs 3.1 times more in Alaska than in New York. 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· 32nd of 51
$52.48
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.