How much rates vary
Facilitymedian $65 · 10th to 90th $38 to $91Professionalmedian $52 · 10th to 90th $40 to $692
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 $39.81 Median $39.81 Typical High $40.74 | Facility | None | $39.81 | $39.81 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $40.74 Typical High $52.48 | Professional | None | $38.90 | $40.74 | $52.48 |
BCBS Texas Setting Professional Modifier None Typical Low $42.66 Median $52.48 Typical High $52.48 | Professional | None | $42.66 | $52.48 | $52.48 |
Christus Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
Lucent Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $28.18 Median $50.12 Typical High $91.20 | Facility | None | $28.18 | $50.12 | $91.20 |
Moda Health Setting Professional Modifier None Typical Low $38.90 Median $40.74 Typical High $58.88 | Professional | None | $38.90 | $40.74 | $58.88 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $81.28 | Professional | None | $54.95 | $54.95 | $81.28 |
Providence Setting Facility Modifier None Typical Low $38.02 Median $64.57 Typical High $91.20 | Facility | None | $38.02 | $64.57 | $91.20 |
Providence Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
United Setting Facility Modifier None Typical Low $57.54 Median $60.26 Typical High $100.00 | Facility | None | $57.54 | $60.26 | $100.00 |
United Setting Professional Modifier None Typical Low $33.88 Median $47.86 Typical High $63.10 | Professional | None | $33.88 | $47.86 | $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 $19.50 Median $20.42 Typical High $26.30 | Professional | 52 · Reduced service | $19.50 | $20.42 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $8.32 Typical High $10.47 | Professional | 53 · Discontinued | $7.76 | $8.32 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.17 Typical High $7.76 | Professional | 55 · Aftercare only | $5.75 | $6.17 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.07 Typical High $5.25 | Professional | 56 · Pre-op care only | $3.89 | $4.07 | $5.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $20.42 Typical High $25.70 | Professional | 52 · Reduced service | $19.50 | $20.42 | $25.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $8.32 Typical High $10.23 | Professional | 53 · Discontinued | $7.76 | $8.32 | $10.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.17 Typical High $7.76 | Professional | 55 · Aftercare only | $5.75 | $6.17 | $7.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.07 Typical High $5.13 | Professional | 56 · Pre-op care only | $3.89 | $4.07 | $5.13 |
Where Texas sits
The same service costs 3.5 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· 43rd of 51
$52.48
HI $166NJ $46.77
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.