How much rates vary
Facilitymedian $120 · 10th to 90th $81 to $123Professionalmedian $87 · 10th to 90th $71 to $1,259
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 $72.44 Median $72.44 Typical High $75.86 | Facility | None | $72.44 | $72.44 | $75.86 |
Aetna Setting Professional Modifier None (both parts) Typical Low $72.44 Median $75.86 Typical High $131.83 | Professional | None (both parts) | $72.44 | $75.86 | $131.83 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $70.79 Median $104.71 Typical High $131.83 | Professional | None (both parts) | $70.79 | $104.71 | $131.83 |
BCBS Texas Setting Professional Modifier None (both parts) Typical Low $77.62 Median $77.62 Typical High $95.50 | Professional | None (both parts) | $77.62 | $77.62 | $95.50 |
Christus Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None (both parts) Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None (both parts) | $70.79 | $70.79 | $97.72 |
Health Smart Setting Professional Modifier None (both parts) Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None (both parts) | $120.23 | $120.23 | $120.23 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $870.96 Median $1,258.93 Typical High $1,258.93 | Professional | None (both parts) | $870.96 | $1,258.93 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $46.77 Median $91.20 Typical High $165.96 | Facility | None | $46.77 | $91.20 | $165.96 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $70.79 Median $75.86 Typical High $144.54 | Professional | None (both parts) | $70.79 | $75.86 | $144.54 |
Molina Setting Professional Modifier None (both parts) Typical Low $81.28 Median $93.33 Typical High $93.33 | Professional | None (both parts) | $81.28 | $93.33 | $93.33 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None (both parts) | $616.60 | $616.60 | $616.60 |
Providence Setting Facility Modifier None Typical Low $69.18 Median $97.72 Typical High $165.96 | Facility | None | $69.18 | $97.72 | $165.96 |
Providence Setting Professional Modifier None (both parts) Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None (both parts) | $70.79 | $70.79 | $97.72 |
United Setting Facility Modifier None Typical Low $79.43 Median $89.13 Typical High $169.82 | Facility | None | $79.43 | $89.13 | $169.82 |
United Setting Professional Modifier None (both parts) Typical Low $56.23 Median $81.28 Typical High $104.71 | Professional | None (both parts) | $56.23 | $81.28 | $104.71 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None (both parts) | $91.20 | $91.20 | $91.20 |
9 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 $35.48 Median $38.02 Typical High $46.77 | Professional | 52 · Reduced service | $35.48 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $15.14 Typical High $18.62 | Professional | 53 · Discontinued | $14.13 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.22 Typical High $14.13 | Professional | 55 · Aftercare only | $10.72 | $11.22 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.59 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.08 | $7.59 | $9.33 |
Christus Setting Professional Modifier 26 · Professional part Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | 26 · Professional part | $100.00 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $38.02 Typical High $44.67 | Professional | 52 · Reduced service | $35.48 | $38.02 | $44.67 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $15.14 Typical High $18.20 | Professional | 53 · Discontinued | $14.13 | $15.14 | $18.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.22 Typical High $13.49 | Professional | 55 · Aftercare only | $10.72 | $11.22 | $13.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.59 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.08 | $7.59 | $8.91 |
Where Texas sits
The same service costs 2.8 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· 33rd of 51
$91.20
HI $195FL $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.