How much rates vary
Facilitymedian $72 · 10th to 90th $32 to $141Professionalmedian $50 · 10th to 90th $34 to $51
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 $50.12 Median $79.43 Typical High $109.65 | Facility | None | $50.12 | $79.43 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $51.29 Typical High $54.95 | Professional | None | $50.12 | $51.29 | $54.95 |
BCBS Texas Setting Facility Modifier None Typical Low $29.51 Median $72.44 Typical High $134.90 | Facility | None | $29.51 | $72.44 | $134.90 |
BCBS Texas Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $74.13 Typical High $158.49 | Facility | None | $50.12 | $74.13 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Moda Health Setting Facility Modifier None Typical Low $25.12 Median $60.26 Typical High $104.71 | Facility | None | $25.12 | $60.26 | $104.71 |
Moda Health Setting Professional Modifier None Typical Low $50.12 Median $51.29 Typical High $51.29 | Professional | None | $50.12 | $51.29 | $51.29 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Providence Setting Facility Modifier None Typical Low $41.69 Median $58.88 Typical High $426.58 | Facility | None | $41.69 | $58.88 | $426.58 |
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 $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Wellpoint Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
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 $25.12 Median $39.81 Typical High $54.95 | Facility | 52 · Reduced service | $25.12 | $39.81 | $54.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.00 Median $16.22 Typical High $21.88 | Facility | 53 · Discontinued | $10.00 | $16.22 | $21.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.59 Median $12.02 Typical High $16.60 | Facility | 55 · Aftercare only | $7.59 | $12.02 | $16.60 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.01 Median $7.94 Typical High $10.96 | Facility | 56 · Pre-op care only | $5.01 | $7.94 | $10.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $25.12 Typical High $27.54 | Professional | 52 · Reduced service | $25.12 | $25.12 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.23 Typical High $10.96 | Professional | 53 · Discontinued | $10.00 | $10.23 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $8.32 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.13 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.01 | $5.13 | $5.50 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $25.12 | $25.12 | $25.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $10.00 | $10.23 | $10.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $7.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $5.01 | $5.13 | $5.13 |
Where Texas sits
The same service costs 1.7 times more in Alaska than in Montana. 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· 6th of 51
$53.70
AK $79.43MT $46.77
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.