How much rates vary
Facilitymedian $132 · 10th to 90th $55 to $245Professionalmedian $63 · 10th to 90th $62 to $69
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 $63.10 Median $97.72 Typical High $134.90 | Facility | None | $63.10 | $97.72 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $69.18 | Professional | None | $63.10 | $63.10 | $69.18 |
BCBS Texas Setting Facility Modifier None Typical Low $53.70 Median $134.90 Typical High $257.04 | Facility | None | $53.70 | $134.90 | $257.04 |
BCBS Texas Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $117.49 Typical High $199.53 | Facility | None | $63.10 | $117.49 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Moda Health Setting Facility Modifier None Typical Low $34.67 Median $74.13 Typical High $151.36 | Facility | None | $34.67 | $74.13 | $151.36 |
Moda Health Setting Professional Modifier None Typical Low $61.66 Median $63.10 Typical High $67.61 | Professional | None | $61.66 | $63.10 | $67.61 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $89.13 Typical High $537.03 | Facility | None | $50.12 | $89.13 | $537.03 |
Providence Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
United Setting Professional Modifier None Typical Low $61.66 Median $66.07 Typical High $69.18 | Professional | None | $61.66 | $66.07 | $69.18 |
Wellpoint Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
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 $30.90 Median $48.98 Typical High $67.61 | Facility | 52 · Reduced service | $30.90 | $48.98 | $67.61 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.59 Median $19.95 Typical High $26.92 | Facility | 53 · Discontinued | $12.59 | $19.95 | $26.92 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.33 Median $14.79 Typical High $20.42 | Facility | 55 · Aftercare only | $9.33 | $14.79 | $20.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.31 Median $9.77 Typical High $13.49 | Facility | 56 · Pre-op care only | $6.31 | $9.77 | $13.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $31.62 Typical High $34.67 | Professional | 52 · Reduced service | $30.90 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $13.80 | Professional | 53 · Discontinued | $12.59 | $12.59 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.55 Typical High $10.23 | Professional | 55 · Aftercare only | $9.33 | $9.55 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $6.92 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $30.90 Typical High $32.36 | Professional | 52 · Reduced service | $30.90 | $30.90 | $32.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.59 Typical High $12.88 | Professional | 53 · Discontinued | $12.30 | $12.59 | $12.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $9.55 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $9.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.31 Typical High $6.46 | Professional | 56 · Pre-op care only | $6.17 | $6.31 | $6.46 |
Where Texas sits
The same service costs 9.3 times more in Alabama than in Oklahoma. 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· 4th of 51
$91.20
AL $525OK $56.23
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.