How much rates vary
Facilitymedian $182 · 10th to 90th $48 to $288Professionalmedian $32 · 10th to 90th $28 to $34
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 $31.62 Median $39.81 Typical High $61.66 | Facility | None | $31.62 | $39.81 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $35.48 | Professional | None | $33.88 | $33.88 | $35.48 |
Ambetter Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
BCBS Texas Setting Facility Modifier None Typical Low $93.33 Median $213.80 Typical High $309.03 | Facility | None | $93.33 | $213.80 | $309.03 |
BCBS Texas Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Christus Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $79.43 Typical High $112.20 | Facility | None | $33.88 | $79.43 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Lucent Health Setting Professional Modifier None Typical Low $32.36 Median $60.26 Typical High $151.36 | Professional | None | $32.36 | $60.26 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $28.18 Median $46.77 Typical High $275.42 | Facility | None | $28.18 | $46.77 | $275.42 |
Moda Health Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $33.88 | Professional | None | $28.18 | $28.18 | $33.88 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $32.36 | Professional | None | $28.18 | $28.18 | $32.36 |
Oscar Health Setting Professional Modifier None Typical Low $28.18 Median $50.12 Typical High $104.71 | Professional | None | $28.18 | $50.12 | $104.71 |
Providence Setting Facility Modifier None Typical Low $28.18 Median $48.98 Typical High $288.40 | Facility | None | $28.18 | $48.98 | $288.40 |
Providence Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
United Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
United Setting Professional Modifier None Typical Low $28.18 Median $30.20 Typical High $32.36 | Professional | None | $28.18 | $30.20 | $32.36 |
Wellpoint Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
17 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 $15.85 Median $19.95 Typical High $30.90 | Facility | 52 · Reduced service | $15.85 | $19.95 | $30.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.31 Median $7.94 Typical High $12.30 | Facility | 53 · Discontinued | $6.31 | $7.94 | $12.30 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.79 Median $6.03 Typical High $9.33 | Facility | 55 · Aftercare only | $4.79 | $6.03 | $9.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.98 Typical High $6.17 | Facility | 56 · Pre-op care only | $3.16 | $3.98 | $6.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $16.98 Typical High $17.38 | Professional | 52 · Reduced service | $16.98 | $16.98 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $7.08 | Professional | 53 · Discontinued | $6.76 | $6.76 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $5.25 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $3.55 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $14.13 Median $17.38 Typical High $34.67 | Facility | 52 · Reduced service | $14.13 | $17.38 | $34.67 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $5.75 Median $6.92 Typical High $13.80 | Facility | 53 · Discontinued | $5.75 | $6.92 | $13.80 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $4.27 Median $5.13 Typical High $10.23 | Facility | 55 · Aftercare only | $4.27 | $5.13 | $10.23 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.47 Typical High $6.92 | Facility | 56 · Pre-op care only | $2.82 | $3.47 | $6.92 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $74.13 Median $257.04 Typical High $269.15 | Facility | JZ · No drug discarded | $74.13 | $257.04 | $269.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $14.13 Typical High $14.79 | Professional | 52 · Reduced service | $14.13 | $14.13 | $14.79 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $5.89 | Professional | 53 · Discontinued | $5.75 | $5.75 | $5.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $4.37 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $4.37 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $2.95 |
Where Texas sits
The same service costs 5.4 times more in Wyoming than in Arizona. 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· 48th of 51
$32.36
WY $162AZ $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.