How much rates vary
Facilitymedian $234 · 10th to 90th $89 to $447Professionalmedian $74 · 10th to 90th $71 to $87
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 $70.79 Median $91.20 Typical High $158.49 | Facility | None | $70.79 | $91.20 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $72.44 | Professional | None | $70.79 | $70.79 | $72.44 |
BCBS Texas Setting Facility Modifier None Typical Low $109.65 Median $275.42 Typical High $467.74 | Facility | None | $109.65 | $275.42 | $467.74 |
BCBS Texas Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $131.83 Typical High $223.87 | Facility | None | $70.79 | $131.83 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Lucent Health Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $134.90 | Professional | None | $87.10 | $109.65 | $134.90 |
Moda Health Setting Facility Modifier None Typical Low $70.79 Median $81.28 Typical High $151.36 | Facility | None | $70.79 | $81.28 | $151.36 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $75.86 | Professional | None | $74.13 | $74.13 | $75.86 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $87.10 | Professional | None | $75.86 | $75.86 | $87.10 |
Oscar Health Setting Professional Modifier None Typical Low $79.43 Median $131.83 Typical High $269.15 | Professional | None | $79.43 | $131.83 | $269.15 |
Providence Setting Facility Modifier None Typical Low $70.79 Median $100.00 Typical High $602.56 | Facility | None | $70.79 | $100.00 | $602.56 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier None Typical Low $74.13 Median $77.62 Typical High $83.18 | Professional | None | $74.13 | $77.62 | $83.18 |
Wellpoint Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
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 $35.48 Median $47.86 Typical High $79.43 | Facility | 52 · Reduced service | $35.48 | $47.86 | $79.43 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.13 Median $19.50 Typical High $32.36 | Facility | 53 · Discontinued | $14.13 | $19.50 | $32.36 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.47 Median $14.45 Typical High $23.99 | Facility | 55 · Aftercare only | $10.47 | $14.45 | $23.99 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.08 Median $9.55 Typical High $15.85 | Facility | 56 · Pre-op care only | $7.08 | $9.55 | $15.85 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $35.48 Typical High $36.31 | Professional | 52 · Reduced service | $35.48 | $35.48 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $14.45 | Professional | 53 · Discontinued | $14.13 | $14.13 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $10.96 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $7.24 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $7.24 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | JZ · No drug discarded | $74.13 | $74.13 | $74.13 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $36.31 Median $44.67 Typical High $75.86 | Facility | 52 · Reduced service | $36.31 | $44.67 | $75.86 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $14.79 Median $17.78 Typical High $30.90 | Facility | 53 · Discontinued | $14.79 | $17.78 | $30.90 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $10.96 Median $13.49 Typical High $22.91 | Facility | 55 · Aftercare only | $10.96 | $13.49 | $22.91 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.91 Typical High $15.14 | Facility | 56 · Pre-op care only | $7.41 | $8.91 | $15.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $36.31 Typical High $38.02 | Professional | 52 · Reduced service | $36.31 | $36.31 | $38.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $15.14 | Professional | 53 · Discontinued | $14.79 | $14.79 | $15.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $11.22 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $11.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $7.59 |
Where Texas sits
The same service costs 1.5 times more in Wyoming than in Florida. 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· 25th of 51
$74.13
WY $107FL $70.79
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.