How much rates vary
Facilitymedian $661 · 10th to 90th $178 to $1,318Professionalmedian $126 · 10th to 90th $120 to $129
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 $123.03 Median $190.55 Typical High $257.04 | Facility | None | $123.03 | $190.55 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $123.03 Typical High $141.25 | Professional | None | $120.23 | $123.03 | $141.25 |
BCBS Setting Facility Modifier None Typical Low $302.00 Median $741.31 Typical High $1,380.38 | Facility | None | $302.00 | $741.31 | $1,380.38 |
BCBS Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $302.00 Typical High $407.38 | Facility | None | $128.82 | $302.00 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Moda Health Setting Facility Modifier None Typical Low $123.03 Median $154.88 Typical High $288.40 | Facility | None | $123.03 | $154.88 | $288.40 |
Moda Health Setting Professional Modifier None Typical Low $120.23 Median $123.03 Typical High $128.82 | Professional | None | $120.23 | $123.03 | $128.82 |
Molina Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Providence Setting Facility Modifier None Typical Low $128.82 Median $177.83 Typical High $1,096.48 | Facility | None | $128.82 | $177.83 | $1,096.48 |
Providence Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Wellpoint Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $61.66 Median $95.50 Typical High $128.82 | Facility | 52 · Reduced service | $61.66 | $95.50 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $24.55 Median $38.02 Typical High $51.29 | Facility | 53 · Discontinued | $24.55 | $38.02 | $51.29 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $28.18 Typical High $38.90 | Facility | 55 · Aftercare only | $18.62 | $28.18 | $38.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.30 Median $19.05 Typical High $25.70 | Facility | 56 · Pre-op care only | $12.30 | $19.05 | $25.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $61.66 Typical High $70.79 | Professional | 52 · Reduced service | $60.26 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $24.55 Typical High $28.18 | Professional | 53 · Discontinued | $23.99 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.62 Typical High $21.38 | Professional | 55 · Aftercare only | $18.20 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.30 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.02 | $12.30 | $14.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $60.26 | $61.66 | $61.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $23.99 | $24.55 | $24.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $18.20 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $12.02 | $12.30 | $12.30 |
Where Texas sits
The same service costs 195.0 times more in Alabama than in Hawaii. 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· 2nd of 51
$331
AL $23,442HI $120
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.