How much rates vary
Facilitymedian $355 · 10th to 90th $102 to $708Professionalmedian $74 · 10th to 90th $30 to $89
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 $72.44 Median $112.20 Typical High $162.18 | Facility | None | $72.44 | $112.20 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $74.13 Typical High $77.62 | Professional | None | $72.44 | $74.13 | $77.62 |
BCBS Setting Facility Modifier None Typical Low $162.18 Median $407.38 Typical High $758.58 | Facility | None | $162.18 | $407.38 | $758.58 |
BCBS Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $138.04 Typical High $234.42 | Facility | None | $72.44 | $138.04 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $95.50 | Professional | None | $72.44 | $72.44 | $95.50 |
Moda Health Setting Facility Modifier None Typical Low $74.13 Median $131.83 Typical High $588.84 | Facility | None | $74.13 | $131.83 | $588.84 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $77.62 | Professional | None | $74.13 | $74.13 | $77.62 |
Molina Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Providence Setting Facility Modifier None Typical Low $72.44 Median $104.71 Typical High $630.96 | Facility | None | $72.44 | $104.71 | $630.96 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $95.50 | Professional | None | $72.44 | $72.44 | $95.50 |
United Setting Professional Modifier None Typical Low $29.51 Median $74.13 Typical High $74.13 | Professional | None | $29.51 | $74.13 | $74.13 |
Wellpoint Setting Professional Modifier None Typical Low $72.44 Median $89.13 Typical High $89.13 | Professional | None | $72.44 | $89.13 | $89.13 |
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 $36.31 Median $58.88 Typical High $79.43 | Facility | 52 · Reduced service | $36.31 | $58.88 | $79.43 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.45 Median $23.44 Typical High $32.36 | Facility | 53 · Discontinued | $14.45 | $23.44 | $32.36 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.96 Median $17.78 Typical High $23.99 | Facility | 55 · Aftercare only | $10.96 | $17.78 | $23.99 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.24 Median $11.75 Typical High $16.22 | Facility | 56 · Pre-op care only | $7.24 | $11.75 | $16.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $37.15 Typical High $38.90 | Professional | 52 · Reduced service | $36.31 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.79 Typical High $15.49 | Professional | 53 · Discontinued | $14.45 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $11.48 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.41 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.24 | $7.41 | $7.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $37.15 Typical High $38.90 | Professional | 52 · Reduced service | $37.15 | $37.15 | $38.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $15.49 | Professional | 53 · Discontinued | $14.79 | $14.79 | $15.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $11.22 Typical High $11.48 | Professional | 55 · Aftercare only | $10.96 | $11.22 | $11.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $7.76 |
Where Texas sits
The same service costs 1.6 times more in Hawaii than in Virginia. 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· 15th of 51
$77.62
HI $115VA $72.44
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.