How much rates vary
Facilitymedian $89 · 10th to 90th $43 to $170Professionalmedian $44 · 10th to 90th $41 to $44
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 $64.57 Typical High $93.33 | Facility | None | $43.65 | $64.57 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $47.86 | Professional | None | $43.65 | $43.65 | $47.86 |
BCBS Texas Setting Facility Modifier None Typical Low $37.15 Median $93.33 Typical High $173.78 | Facility | None | $37.15 | $93.33 | $173.78 |
BCBS Texas Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $81.28 Typical High $138.04 | Facility | None | $43.65 | $81.28 | $138.04 |
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 $42.66 Median $53.70 Typical High $89.13 | Facility | None | $42.66 | $53.70 | $89.13 |
Moda Health Setting Professional Modifier None Typical Low $42.66 Median $43.65 Typical High $46.77 | Professional | None | $42.66 | $43.65 | $46.77 |
Molina Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Providence Setting Facility Modifier None Typical Low $43.65 Median $61.66 Typical High $371.54 | Facility | None | $43.65 | $61.66 | $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 Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Wellpoint Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
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 $33.88 Typical High $46.77 | Facility | 52 · Reduced service | $21.88 | $33.88 | $46.77 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.71 Median $13.49 Typical High $18.62 | Facility | 53 · Discontinued | $8.71 | $13.49 | $18.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.46 Median $10.23 Typical High $14.13 | Facility | 55 · Aftercare only | $6.46 | $10.23 | $14.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.76 Typical High $9.33 | Facility | 56 · Pre-op care only | $4.37 | $6.76 | $9.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $21.88 Typical High $23.99 | Professional | 52 · Reduced service | $21.88 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $9.55 | Professional | 53 · Discontinued | $8.71 | $8.71 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.61 Typical High $7.24 | Professional | 55 · Aftercare only | $6.46 | $6.61 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.79 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $21.38 Typical High $22.39 | Professional | 52 · Reduced service | $21.38 | $21.38 | $22.39 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.71 Typical High $8.91 | Professional | 53 · Discontinued | $8.51 | $8.71 | $8.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $6.61 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $6.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.37 Typical High $4.47 | Professional | 56 · Pre-op care only | $4.27 | $4.37 | $4.47 |
Where Texas sits
The same service costs 1.6 times more in Arizona than in Maryland. 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
$61.66
AZ $69.18MD $42.66
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.