How much rates vary
Facilitymedian $89 · 10th to 90th $60 to $145Professionalmedian $83 · 10th to 90th $63 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 $63.10 Median $63.10 Typical High $64.57 | Facility | None | $63.10 | $63.10 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $64.57 Typical High $83.18 | Professional | None | $61.66 | $64.57 | $83.18 |
BCBS Texas Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Christus Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | None | $64.57 | $64.57 | $89.13 |
Lucent Health Setting Professional Modifier None Typical Low $912.01 Median $1,445.44 Typical High $1,445.44 | Professional | None | $912.01 | $1,445.44 | $1,445.44 |
Moda Health Setting Facility Modifier None Typical Low $45.71 Median $79.43 Typical High $144.54 | Facility | None | $45.71 | $79.43 | $144.54 |
Moda Health Setting Professional Modifier None Typical Low $61.66 Median $64.57 Typical High $95.50 | Professional | None | $61.66 | $64.57 | $95.50 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $81.28 | Professional | None | $75.86 | $75.86 | $81.28 |
Providence Setting Facility Modifier None Typical Low $60.26 Median $89.13 Typical High $144.54 | Facility | None | $60.26 | $89.13 | $144.54 |
Providence Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | None | $64.57 | $64.57 | $89.13 |
United Setting Facility Modifier None Typical Low $70.79 Median $87.10 Typical High $162.18 | Facility | None | $70.79 | $87.10 | $162.18 |
United Setting Professional Modifier None Typical Low $53.70 Median $75.86 Typical High $100.00 | Professional | None | $53.70 | $75.86 | $100.00 |
Wellpoint Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $85.11 | Professional | None | $83.18 | $83.18 | $85.11 |
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 $30.90 Median $32.36 Typical High $41.69 | Professional | 52 · Reduced service | $30.90 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $13.18 Typical High $16.60 | Professional | 53 · Discontinued | $12.30 | $13.18 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.77 Typical High $12.30 | Professional | 55 · Aftercare only | $9.33 | $9.77 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.46 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.17 | $6.46 | $8.32 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $32.36 Typical High $40.74 | Professional | 52 · Reduced service | $30.90 | $32.36 | $40.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $13.18 Typical High $16.22 | Professional | 53 · Discontinued | $12.30 | $13.18 | $16.22 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.77 Typical High $12.30 | Professional | 55 · Aftercare only | $9.33 | $9.77 | $12.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.46 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.17 | $6.46 | $8.13 |
Where Texas sits
The same service costs 2.6 times more in Hawaii 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· 40th of 51
$83.18
HI $186FL $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.