How much rates vary
Facilitymedian $83 · 10th to 90th $33 to $148Professionalmedian $55 · 10th to 90th $30 to $59
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 $83.18 Typical High $117.49 | Facility | None | $43.65 | $83.18 | $117.49 |
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 Facility Modifier None Typical Low $33.11 Median $85.11 Typical High $158.49 | Facility | None | $33.11 | $85.11 | $158.49 |
BCBS Texas Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $83.18 Typical High $141.25 | Facility | None | $43.65 | $83.18 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Moda Health Setting Facility Modifier None Typical Low $54.95 Median $75.86 Typical High $131.83 | Facility | None | $54.95 | $75.86 | $131.83 |
Moda Health Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $60.26 | Professional | None | $54.95 | $54.95 | $60.26 |
Molina Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Providence Setting Facility Modifier None Typical Low $43.65 Median $63.10 Typical High $371.54 | Facility | None | $43.65 | $63.10 | $371.54 |
Providence Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Wellpoint Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
12 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 Facility Modifier 52 · Reduced service Typical Low $21.88 Median $43.65 Typical High $58.88 | Facility | 52 · Reduced service | $21.88 | $43.65 | $58.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.71 Median $17.38 Typical High $23.44 | Facility | 53 · Discontinued | $8.71 | $17.38 | $23.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.61 Median $12.88 Typical High $17.78 | Facility | 55 · Aftercare only | $6.61 | $12.88 | $17.78 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.37 Median $8.71 Typical High $11.75 | Facility | 56 · Pre-op care only | $4.37 | $8.71 | $11.75 |
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 $6.61 Median $6.61 Typical High $7.24 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $7.24 |
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 $26.92 Median $27.54 Typical High $28.18 | Professional | 52 · Reduced service | $26.92 | $27.54 | $28.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $11.22 | Professional | 53 · Discontinued | $10.96 | $10.96 | $11.22 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.32 Typical High $8.51 | Professional | 55 · Aftercare only | $8.13 | $8.32 | $8.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.50 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.37 | $5.50 | $5.62 |
Where Texas sits
The same service costs 2.0 times more in Alaska than in Wyoming. 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· 5th of 51
$61.66
AK $81.28WY $39.81
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.