How much rates vary
Facilitymedian $63 · 10th to 90th $41 to $95Professionalmedian $54 · 10th to 90th $43 to $676
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 $42.66 Median $42.66 Typical High $43.65 | Facility | None | $42.66 | $42.66 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $43.65 Typical High $54.95 | Professional | None | $41.69 | $43.65 | $54.95 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
BCBS Texas Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $56.23 | Professional | None | $44.67 | $44.67 | $56.23 |
Christus Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Lucent Health Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $676.08 | Professional | None | $616.60 | $676.08 | $676.08 |
Moda Health Setting Facility Modifier None Typical Low $28.18 Median $53.70 Typical High $95.50 | Facility | None | $28.18 | $53.70 | $95.50 |
Moda Health Setting Professional Modifier None Typical Low $41.69 Median $43.65 Typical High $63.10 | Professional | None | $41.69 | $43.65 | $63.10 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $81.28 | Professional | None | $53.70 | $53.70 | $81.28 |
Providence Setting Facility Modifier None Typical Low $40.74 Median $63.10 Typical High $95.50 | Facility | None | $40.74 | $63.10 | $95.50 |
Providence Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
United Setting Facility Modifier None Typical Low $56.23 Median $58.88 Typical High $100.00 | Facility | None | $56.23 | $58.88 | $100.00 |
United Setting Professional Modifier None Typical Low $33.88 Median $48.98 Typical High $63.10 | Professional | None | $33.88 | $48.98 | $63.10 |
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 $20.89 Median $21.88 Typical High $27.54 | Professional | 52 · Reduced service | $20.89 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.71 Typical High $10.96 | Professional | 53 · Discontinued | $8.32 | $8.71 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.61 Typical High $8.13 | Professional | 55 · Aftercare only | $6.17 | $6.61 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.37 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.17 | $4.37 | $5.50 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $21.88 Typical High $27.54 | Professional | 52 · Reduced service | $20.89 | $21.88 | $27.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.71 Typical High $10.96 | Professional | 53 · Discontinued | $8.32 | $8.71 | $10.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.61 Typical High $8.13 | Professional | 55 · Aftercare only | $6.17 | $6.61 | $8.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.37 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.17 | $4.37 | $5.50 |
Where Texas sits
The same service costs 3.2 times more in Hawaii than in New Jersey. 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· 39th of 51
$53.70
HI $148NJ $45.71
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.