How much rates vary
Facilitymedian $79 · 10th to 90th $56 to $91Professionalmedian $58 · 10th to 90th $43 to $891
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 $53.70 Median $53.70 Typical High $56.23 | Facility | None | $53.70 | $53.70 | $56.23 |
Aetna Setting Professional Modifier None (both parts) Typical Low $52.48 Median $56.23 Typical High $97.72 | Professional | None (both parts) | $52.48 | $56.23 | $97.72 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $61.66 Median $91.20 Typical High $123.03 | Professional | None (both parts) | $61.66 | $91.20 | $123.03 |
BCBS Texas Setting Professional Modifier None (both parts) Typical Low $57.54 Median $57.54 Typical High $70.79 | Professional | None (both parts) | $57.54 | $57.54 | $70.79 |
Baylor Scott & White Setting Professional Modifier None (both parts) Typical Low $91.20 Median $91.20 Typical High $125.89 | Professional | None (both parts) | $91.20 | $91.20 | $125.89 |
Christus Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $42.66 Median $42.66 Typical High $57.54 | Professional | None (both parts) | $42.66 | $42.66 | $57.54 |
Health Smart Setting Professional Modifier None (both parts) Typical Low $74.13 Median $74.13 Typical High $75.86 | Professional | None (both parts) | $74.13 | $74.13 | $75.86 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $602.56 Median $891.25 Typical High $891.25 | Professional | None (both parts) | $602.56 | $891.25 | $891.25 |
Moda Health Setting Facility Modifier None Typical Low $28.84 Median $67.61 Typical High $123.03 | Facility | None | $28.84 | $67.61 | $123.03 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $52.48 Median $56.23 Typical High $97.72 | Professional | None (both parts) | $52.48 | $56.23 | $97.72 |
Molina Setting Professional Modifier None (both parts) Typical Low $64.57 Median $64.57 Typical High $81.28 | Professional | None (both parts) | $64.57 | $64.57 | $81.28 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None (both parts) | $446.68 | $446.68 | $446.68 |
Providence Setting Facility Modifier None Typical Low $51.29 Median $57.54 Typical High $123.03 | Facility | None | $51.29 | $57.54 | $123.03 |
Providence Setting Professional Modifier None (both parts) Typical Low $42.66 Median $42.66 Typical High $57.54 | Professional | None (both parts) | $42.66 | $42.66 | $57.54 |
United Setting Facility Modifier None Typical Low $43.65 Median $51.29 Typical High $104.71 | Facility | None | $43.65 | $51.29 | $104.71 |
United Setting Professional Modifier None (both parts) Typical Low $34.67 Median $50.12 Typical High $64.57 | Professional | None (both parts) | $34.67 | $50.12 | $64.57 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None (both parts) | $54.95 | $54.95 | $54.95 |
12 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 $25.70 Median $27.54 Typical High $32.36 | Professional | 52 · Reduced service | $25.70 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.96 Typical High $12.88 | Professional | 53 · Discontinued | $10.23 | $10.96 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $8.13 Typical High $9.77 | Professional | 55 · Aftercare only | $7.76 | $8.13 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.50 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.13 | $5.50 | $6.46 |
Christus Setting Professional Modifier 26 · Professional part Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 26 · Professional part | $74.13 | $74.13 | $74.13 |
Cigna Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | RR · Rental | $5.75 | $5.75 | $5.75 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $27.54 Typical High $32.36 | Professional | 52 · Reduced service | $25.12 | $27.54 | $32.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.96 Typical High $12.88 | Professional | 53 · Discontinued | $10.00 | $10.96 | $12.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $8.13 Typical High $9.55 | Professional | 55 · Aftercare only | $7.59 | $8.13 | $9.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.50 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.01 | $5.50 | $6.46 |
Moda Health Setting Professional Modifier KX · Policy requirements met Typical Low $95.50 Median $102.33 Typical High $117.49 | Professional | KX · Policy requirements met | $95.50 | $102.33 | $117.49 |
Providence Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | RR · Rental | $5.75 | $5.75 | $5.75 |
Where Texas sits
The same service costs 2.6 times more in Hawaii 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· 29th of 51
$57.54
HI $117DE $44.67
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.