How much rates vary
Facilitymedian $316 · 10th to 90th $115 to $589Professionalmedian $93 · 10th to 90th $89 to $166
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 $89.13 Median $147.91 Typical High $204.17 | Facility | None | $89.13 | $147.91 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $100.00 | Professional | None | $89.13 | $91.20 | $100.00 |
BCBS Texas Setting Facility Modifier None Typical Low $147.91 Median $363.08 Typical High $602.56 | Facility | None | $147.91 | $363.08 | $602.56 |
BCBS Texas Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $169.82 Typical High $288.40 | Facility | None | $89.13 | $169.82 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Moda Health Setting Facility Modifier None Typical Low $93.33 Median $120.23 Typical High $223.87 | Facility | None | $93.33 | $120.23 | $223.87 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $97.72 | Professional | None | $93.33 | $93.33 | $97.72 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Providence Setting Facility Modifier None Typical Low $89.13 Median $128.82 Typical High $776.25 | Facility | None | $89.13 | $128.82 | $776.25 |
Providence Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Wellpoint Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
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 $44.67 Median $74.13 Typical High $100.00 | Facility | 52 · Reduced service | $44.67 | $74.13 | $100.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.20 Median $29.51 Typical High $40.74 | Facility | 53 · Discontinued | $18.20 | $29.51 | $40.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $13.49 Median $22.39 Typical High $30.20 | Facility | 55 · Aftercare only | $13.49 | $22.39 | $30.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.91 Median $14.79 Typical High $20.42 | Facility | 56 · Pre-op care only | $8.91 | $14.79 | $20.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $45.71 Typical High $48.98 | Professional | 52 · Reduced service | $44.67 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $19.95 | Professional | 53 · Discontinued | $18.20 | $18.20 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $14.79 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.12 Typical High $10.00 | Professional | 56 · Pre-op care only | $8.91 | $9.12 | $10.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $46.77 Typical High $47.86 | Professional | 52 · Reduced service | $46.77 | $46.77 | $47.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $19.05 | Professional | 53 · Discontinued | $18.62 | $18.62 | $19.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.13 Typical High $14.45 | Professional | 55 · Aftercare only | $13.80 | $14.13 | $14.45 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $9.55 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $9.55 |
Where Texas sits
The same service costs 5.9 times more in Alabama than in Florida. 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
$166
AL $525FL $89.13
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.