How much rates vary
Facilitymedian $91 · 10th to 90th $39 to $166Professionalmedian $40 · 10th to 90th $39 to $40
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 $39.81 Median $63.10 Typical High $87.10 | Facility | None | $39.81 | $63.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $43.65 | Professional | None | $39.81 | $39.81 | $43.65 |
BCBS Texas Setting Facility Modifier None Typical Low $38.90 Median $100.00 Typical High $169.82 | Facility | None | $38.90 | $100.00 | $169.82 |
BCBS Texas Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $57.54 Typical High $123.03 | Facility | None | $38.90 | $57.54 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Moda Health Setting Facility Modifier None Typical Low $39.81 Median $52.48 Typical High $95.50 | Facility | None | $39.81 | $52.48 | $95.50 |
Moda Health Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $43.65 | Professional | None | $39.81 | $39.81 | $43.65 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Providence Setting Facility Modifier None Typical Low $38.90 Median $57.54 Typical High $331.13 | Facility | None | $38.90 | $57.54 | $331.13 |
Providence Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
United Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
United Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Wellpoint Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
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 $19.95 Median $31.62 Typical High $43.65 | Facility | 52 · Reduced service | $19.95 | $31.62 | $43.65 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.94 Median $12.59 Typical High $17.38 | Facility | 53 · Discontinued | $7.94 | $12.59 | $17.38 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.03 Median $9.55 Typical High $12.88 | Facility | 55 · Aftercare only | $6.03 | $9.55 | $12.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.98 Median $6.31 Typical High $8.71 | Facility | 56 · Pre-op care only | $3.98 | $6.31 | $8.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $19.95 Typical High $21.88 | Professional | 52 · Reduced service | $19.95 | $19.95 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.13 Typical High $8.71 | Professional | 53 · Discontinued | $7.94 | $8.13 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $6.61 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $4.37 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $19.95 Typical High $20.89 | Professional | 52 · Reduced service | $19.95 | $19.95 | $20.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.13 Typical High $8.32 | Professional | 53 · Discontinued | $7.94 | $8.13 | $8.32 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $6.17 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $6.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $4.17 |
Where Texas sits
The same service costs 1.6 times more in Arizona 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· 3rd of 51
$56.23
AZ $63.10WY $38.90
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.