How much rates vary
Facilitymedian $263 · 10th to 90th $87 to $501Professionalmedian $66 · 10th to 90th $60 to $85
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 $60.26 Median $114.82 Typical High $165.96 | Facility | None | $60.26 | $114.82 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $61.66 | Professional | None | $60.26 | $60.26 | $61.66 |
BCBS Texas Setting Facility Modifier None Typical Low $123.03 Median $309.03 Typical High $512.86 | Facility | None | $123.03 | $309.03 | $512.86 |
BCBS Texas Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $123.03 Typical High $190.55 | Facility | None | $60.26 | $123.03 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Lucent Health Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $169.82 | Professional | None | $120.23 | $138.04 | $169.82 |
Moda Health Setting Facility Modifier None Typical Low $77.62 Median $93.33 Typical High $158.49 | Facility | None | $77.62 | $93.33 | $158.49 |
Moda Health Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $79.43 | Professional | None | $77.62 | $77.62 | $79.43 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $120.23 | Professional | None | $104.71 | $104.71 | $120.23 |
Oscar Health Setting Professional Modifier None Typical Low $79.43 Median $134.90 Typical High $281.84 | Professional | None | $79.43 | $134.90 | $281.84 |
Providence Setting Facility Modifier None Typical Low $60.26 Median $87.10 Typical High $512.86 | Facility | None | $60.26 | $87.10 | $512.86 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $87.10 | Professional | None | $77.62 | $81.28 | $87.10 |
Wellpoint Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
13 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 $30.20 Median $57.54 Typical High $83.18 | Facility | 52 · Reduced service | $30.20 | $57.54 | $83.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.02 Median $23.44 Typical High $33.11 | Facility | 53 · Discontinued | $12.02 | $23.44 | $33.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.91 Median $17.38 Typical High $25.12 | Facility | 55 · Aftercare only | $8.91 | $17.38 | $25.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.03 Median $11.75 Typical High $16.60 | Facility | 56 · Pre-op care only | $6.03 | $11.75 | $16.60 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $30.20 Typical High $30.90 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.30 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $9.33 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.17 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | JZ · No drug discarded | $83.18 | $83.18 | $83.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $38.02 Typical High $39.81 | Professional | 52 · Reduced service | $38.02 | $38.02 | $39.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $15.85 | Professional | 53 · Discontinued | $15.49 | $15.49 | $15.85 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $11.75 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $11.75 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $7.94 |
Where Texas sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 19th of 51
$72.44
HI $158CO $60.26
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.