How much rates vary
Facilitymedian $51 · 10th to 90th $34 to $95Professionalmedian $42 · 10th to 90th $30 to $309
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 $40.74 Median $58.88 Typical High $87.10 | Facility | None | $40.74 | $58.88 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $41.69 Typical High $42.66 | Professional | None | $40.74 | $41.69 | $42.66 |
BCBS Texas Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $70.79 Typical High $95.50 | Facility | None | $30.20 | $70.79 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Lucent Health Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $309.03 | Professional | None | $229.09 | $309.03 | $309.03 |
Moda Health Setting Facility Modifier None Typical Low $40.74 Median $50.12 Typical High $83.18 | Facility | None | $40.74 | $50.12 | $83.18 |
Moda Health Setting Professional Modifier None Typical Low $40.74 Median $41.69 Typical High $41.69 | Professional | None | $40.74 | $41.69 | $41.69 |
Providence Setting Facility Modifier None Typical Low $30.20 Median $46.77 Typical High $257.04 | Facility | None | $30.20 | $46.77 | $257.04 |
Providence Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Professional Modifier None Typical Low $40.74 Median $42.66 Typical High $44.67 | Professional | None | $40.74 | $42.66 | $44.67 |
Wellpoint Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
16 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 $20.42 Median $29.51 Typical High $43.65 | Facility | 52 · Reduced service | $20.42 | $29.51 | $43.65 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.13 Median $11.75 Typical High $17.78 | Facility | 53 · Discontinued | $8.13 | $11.75 | $17.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.17 Median $8.71 Typical High $13.18 | Facility | 55 · Aftercare only | $6.17 | $8.71 | $13.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.89 Typical High $8.71 | Facility | 56 · Pre-op care only | $4.07 | $5.89 | $8.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $20.89 Typical High $21.38 | Professional | 52 · Reduced service | $20.42 | $20.89 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.32 Typical High $8.51 | Professional | 53 · Discontinued | $8.13 | $8.32 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $6.17 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.17 Typical High $4.27 | Professional | 56 · Pre-op care only | $4.07 | $4.17 | $4.27 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $20.42 Median $25.12 Typical High $41.69 | Facility | 52 · Reduced service | $20.42 | $25.12 | $41.69 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $8.13 Median $10.00 Typical High $16.98 | Facility | 53 · Discontinued | $8.13 | $10.00 | $16.98 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $6.17 Median $7.59 Typical High $12.59 | Facility | 55 · Aftercare only | $6.17 | $7.59 | $12.59 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.01 Typical High $8.32 | Facility | 56 · Pre-op care only | $4.07 | $5.01 | $8.32 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $20.42 | $20.89 | $20.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $8.13 | $8.32 | $8.32 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $6.17 | $6.31 | $6.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $4.07 | $4.17 | $4.17 |
Where Texas sits
The same service costs 2.0 times more in Alaska than in New Mexico. 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· 18th of 51
$41.69
AK $60.26NM $30.20
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.