How much rates vary
Facilitymedian $191 · 10th to 90th $117 to $282Professionalmedian $162 · 10th to 90th $123 to $1,995
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 $123.03 Median $123.03 Typical High $128.82 | Facility | None | $123.03 | $123.03 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $158.49 | Professional | None | $120.23 | $128.82 | $158.49 |
BCBS Texas Setting Professional Modifier None Typical Low $131.83 Median $162.18 Typical High $162.18 | Professional | None | $131.83 | $162.18 | $162.18 |
Christus Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Lucent Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,479.11 | $1,995.26 | $1,995.26 |
Moda Health Setting Facility Modifier None Typical Low $83.18 Median $154.88 Typical High $281.84 | Facility | None | $83.18 | $154.88 | $281.84 |
Moda Health Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $199.53 | Professional | None | $120.23 | $128.82 | $199.53 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $141.25 Typical High $141.25 | Professional | None | $81.28 | $141.25 | $141.25 |
Providence Setting Facility Modifier None Typical Low $117.49 Median $190.55 Typical High $281.84 | Facility | None | $117.49 | $190.55 | $281.84 |
Providence Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
United Setting Facility Modifier None Typical Low $147.91 Median $151.36 Typical High $302.00 | Facility | None | $147.91 | $151.36 | $302.00 |
United Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $186.21 | Professional | None | $100.00 | $144.54 | $186.21 |
Wellpoint Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
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 $60.26 Median $63.10 Typical High $79.43 | Professional | 52 · Reduced service | $60.26 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $25.70 Typical High $31.62 | Professional | 53 · Discontinued | $23.99 | $25.70 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.05 Typical High $23.99 | Professional | 55 · Aftercare only | $18.20 | $19.05 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.88 Typical High $15.85 | Professional | 56 · Pre-op care only | $12.02 | $12.88 | $15.85 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $63.10 Typical High $79.43 | Professional | 52 · Reduced service | $60.26 | $63.10 | $79.43 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $25.70 Typical High $31.62 | Professional | 53 · Discontinued | $23.99 | $25.70 | $31.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.05 Typical High $23.44 | Professional | 55 · Aftercare only | $18.20 | $19.05 | $23.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.88 Typical High $15.85 | Professional | 56 · Pre-op care only | $12.02 | $12.88 | $15.85 |
Where Texas sits
The same service costs 2.3 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· 32nd of 51
$162
HI $324NJ $138
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.