How much rates vary
Facilitymedian $41 · 10th to 90th $29 to $105Professionalmedian $32 · 10th to 90th $29 to $170
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 $28.84 Median $31.62 Typical High $61.66 | Facility | None | $28.84 | $31.62 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $29.51 | Professional | None | $28.84 | $28.84 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $75.86 Typical High $104.71 | Facility | None | $32.36 | $75.86 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Lucent Health Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $169.82 | Professional | None | $125.89 | $169.82 | $169.82 |
Moda Health Setting Facility Modifier None Typical Low $28.84 Median $31.62 Typical High $43.65 | Facility | None | $28.84 | $31.62 | $43.65 |
Moda Health Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $29.51 | Professional | None | $28.84 | $28.84 | $29.51 |
Molina Setting Professional Modifier None Typical Low $19.95 Median $28.84 Typical High $38.90 | Professional | None | $19.95 | $28.84 | $38.90 |
Oscar Health Setting Professional Modifier None Typical Low $30.90 Median $60.26 Typical High $104.71 | Professional | None | $30.90 | $60.26 | $104.71 |
Providence Setting Facility Modifier None Typical Low $28.84 Median $45.71 Typical High $275.42 | Facility | None | $28.84 | $45.71 | $275.42 |
Providence Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
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 $28.84 Median $30.20 Typical High $32.36 | Professional | None | $28.84 | $30.20 | $32.36 |
Wellpoint Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
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 $14.13 Median $15.85 Typical High $30.90 | Facility | 52 · Reduced service | $14.13 | $15.85 | $30.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.75 Median $6.31 Typical High $12.30 | Facility | 53 · Discontinued | $5.75 | $6.31 | $12.30 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.27 Median $4.79 Typical High $9.33 | Facility | 55 · Aftercare only | $4.27 | $4.79 | $9.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.16 Typical High $6.17 | Facility | 56 · Pre-op care only | $2.82 | $3.16 | $6.17 |
Aetna 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 |
Aetna 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 |
Aetna 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 |
Aetna 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 |
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
Rates are fairly even across states for this service. 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· 15th of 51
$32.36
AK $42.66MD $28.84
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.