How much rates vary
Facilitymedian $52 · 10th to 90th $19 to $58Professionalmedian $45 · 10th to 90th $32 to $398
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 $30.90 Median $30.90 Typical High $32.36 | Facility | None | $30.90 | $30.90 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $43.65 | Professional | None | $30.90 | $32.36 | $43.65 |
BCBS Texas Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $47.86 | Professional | None | $37.15 | $37.15 | $47.86 |
Christus Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $52.48 | Professional | None | $44.67 | $44.67 | $52.48 |
Lucent Health Setting Professional Modifier None Typical Low $389.05 Median $398.11 Typical High $398.11 | Professional | None | $389.05 | $398.11 | $398.11 |
Moda Health Setting Facility Modifier None Typical Low $19.05 Median $46.77 Typical High $57.54 | Facility | None | $19.05 | $46.77 | $57.54 |
Moda Health Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $48.98 | Professional | None | $30.90 | $32.36 | $48.98 |
Providence Setting Facility Modifier None Typical Low $19.05 Median $52.48 Typical High $57.54 | Facility | None | $19.05 | $52.48 | $57.54 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $52.48 | Professional | None | $44.67 | $44.67 | $52.48 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $93.33 | Facility | None | $79.43 | $79.43 | $93.33 |
United Setting Professional Modifier None Typical Low $29.51 Median $46.77 Typical High $66.07 | Professional | None | $29.51 | $46.77 | $66.07 |
Wellpoint Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
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 $15.49 Median $16.22 Typical High $19.95 | Professional | 52 · Reduced service | $15.49 | $16.22 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.46 Typical High $8.13 | Professional | 53 · Discontinued | $6.31 | $6.46 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.90 Typical High $6.03 | Professional | 55 · Aftercare only | $4.68 | $4.90 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.24 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.09 | $3.24 | $4.07 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $16.22 Typical High $19.05 | Professional | 52 · Reduced service | $15.49 | $16.22 | $19.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.46 Typical High $7.59 | Professional | 53 · Discontinued | $6.31 | $6.46 | $7.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.90 Typical High $5.62 | Professional | 55 · Aftercare only | $4.68 | $4.90 | $5.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.24 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.09 | $3.24 | $3.80 |
Where Texas sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 31st of 51
$47.86
HI $93.33UT $36.31
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.