How much rates vary
Facilitymedian $123 · 10th to 90th $87 to $240Professionalmedian $112 · 10th to 90th $89 to $1,445
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 $104.71 Median $104.71 Typical High $109.65 | Facility | None | $104.71 | $104.71 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $109.65 Typical High $125.89 | Professional | None | $102.33 | $109.65 | $125.89 |
BCBS Texas Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $141.25 | Professional | None | $112.20 | $141.25 | $141.25 |
Christus Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,174.90 | $1,445.44 | $1,445.44 |
Moda Health Setting Facility Modifier None Typical Low $56.23 Median $131.83 Typical High $239.88 | Facility | None | $56.23 | $131.83 | $239.88 |
Moda Health Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $141.25 | Professional | None | $100.00 | $109.65 | $141.25 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $131.83 Typical High $131.83 | Professional | None | $81.28 | $131.83 | $131.83 |
Oscar Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $123.03 Typical High $239.88 | Facility | None | $100.00 | $123.03 | $239.88 |
Providence Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
United Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $204.17 | Facility | None | $87.10 | $100.00 | $204.17 |
United Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $125.89 | Professional | None | $67.61 | $97.72 | $125.89 |
Wellpoint Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
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 $51.29 Median $54.95 Typical High $63.10 | Professional | 52 · Reduced service | $51.29 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $21.88 Typical High $25.12 | Professional | 53 · Discontinued | $20.42 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $16.22 Typical High $19.05 | Professional | 55 · Aftercare only | $15.49 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.96 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.23 | $10.96 | $12.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $53.70 Typical High $58.88 | Professional | 52 · Reduced service | $50.12 | $53.70 | $58.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $21.38 Typical High $23.99 | Professional | 53 · Discontinued | $20.42 | $21.38 | $23.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.22 Typical High $17.78 | Professional | 55 · Aftercare only | $15.14 | $16.22 | $17.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.72 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.00 | $10.72 | $12.02 |
Where Texas sits
The same service costs 2.5 times more in Hawaii 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· 27th of 51
$117
HI $219AZ $89.13
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.