How much rates vary
Facilitymedian $126 · 10th to 90th $79 to $186Professionalmedian $112 · 10th to 90th $81 to $1,862
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 $81.28 Median $81.28 Typical High $85.11 | Facility | None | $81.28 | $81.28 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $85.11 Typical High $109.65 | Professional | None | $81.28 | $85.11 | $109.65 |
BCBS Texas Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $109.65 | Professional | None | $87.10 | $109.65 | $109.65 |
Christus Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $125.89 | Professional | None | $91.20 | $91.20 | $125.89 |
Lucent Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,202.26 | $1,862.09 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $58.88 Median $102.33 Typical High $186.21 | Facility | None | $58.88 | $102.33 | $186.21 |
Moda Health Setting Professional Modifier None Typical Low $81.28 Median $85.11 Typical High $151.36 | Professional | None | $81.28 | $85.11 | $151.36 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $102.33 | Professional | None | $81.28 | $102.33 | $102.33 |
Oscar Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Providence Setting Facility Modifier None Typical Low $79.43 Median $125.89 Typical High $186.21 | Facility | None | $79.43 | $125.89 | $186.21 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $125.89 | Professional | None | $91.20 | $91.20 | $125.89 |
United Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $213.80 | Facility | None | $87.10 | $100.00 | $213.80 |
United Setting Professional Modifier None Typical Low $70.79 Median $102.33 Typical High $131.83 | Professional | None | $70.79 | $102.33 | $131.83 |
Wellpoint Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
8 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 Professional Modifier 52 · Reduced service Typical Low $39.81 Median $42.66 Typical High $53.70 | Professional | 52 · Reduced service | $39.81 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.98 Typical High $21.38 | Professional | 53 · Discontinued | $16.22 | $16.98 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.88 Typical High $16.22 | Professional | 55 · Aftercare only | $12.02 | $12.88 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.51 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.13 | $8.51 | $10.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $42.66 Typical High $53.70 | Professional | 52 · Reduced service | $39.81 | $42.66 | $53.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.98 Typical High $21.38 | Professional | 53 · Discontinued | $16.22 | $16.98 | $21.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.88 Typical High $15.85 | Professional | 55 · Aftercare only | $12.02 | $12.88 | $15.85 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.51 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.13 | $8.51 | $10.72 |
Where Texas sits
The same service costs 2.4 times more in Hawaii than in Delaware. 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· 37th of 51
$112
HI $219DE $91.20
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.