How much rates vary
Facilitymedian $41 · 10th to 90th $28 to $66Professionalmedian $38 · 10th to 90th $29 to $479
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 $28.84 Median $28.84 Typical High $30.20 | Facility | None | $28.84 | $28.84 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $30.20 Typical High $37.15 | Professional | None | $28.18 | $30.20 | $37.15 |
BCBS Texas Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Christus Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $40.74 | Professional | None | $29.51 | $29.51 | $40.74 |
Lucent Health Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $478.63 | Professional | None | $407.38 | $478.63 | $478.63 |
Moda Health Setting Facility Modifier None Typical Low $19.95 Median $36.31 Typical High $66.07 | Facility | None | $19.95 | $36.31 | $66.07 |
Moda Health Setting Professional Modifier None Typical Low $28.18 Median $30.20 Typical High $47.86 | Professional | None | $28.18 | $30.20 | $47.86 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $81.28 | Professional | None | $36.31 | $36.31 | $81.28 |
Providence Setting Facility Modifier None Typical Low $27.54 Median $40.74 Typical High $66.07 | Facility | None | $27.54 | $40.74 | $66.07 |
Providence Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $40.74 | Professional | None | $29.51 | $29.51 | $40.74 |
United Setting Facility Modifier None Typical Low $36.31 Median $40.74 Typical High $72.44 | Facility | None | $36.31 | $40.74 | $72.44 |
United Setting Professional Modifier None Typical Low $23.99 Median $34.67 Typical High $44.67 | Professional | None | $23.99 | $34.67 | $44.67 |
Wellpoint Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
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 $14.13 Median $15.14 Typical High $18.62 | Professional | 52 · Reduced service | $14.13 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $6.03 Typical High $7.41 | Professional | 53 · Discontinued | $5.62 | $6.03 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.47 Typical High $5.62 | Professional | 55 · Aftercare only | $4.27 | $4.47 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.02 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.82 | $3.02 | $3.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $15.14 Typical High $18.62 | Professional | 52 · Reduced service | $14.13 | $15.14 | $18.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $6.03 Typical High $7.41 | Professional | 53 · Discontinued | $5.62 | $6.03 | $7.41 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.47 Typical High $5.62 | Professional | 55 · Aftercare only | $4.27 | $4.47 | $5.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.02 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.82 | $3.02 | $3.72 |
Where Texas sits
The same service costs 2.7 times more in Montana 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· 33rd of 51
$38.02
MT $83.18DE $30.90
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.