How much rates vary
Facilitymedian $79 · 10th to 90th $68 to $120Professionalmedian $65 · 10th to 90th $60 to $1,318
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 $60.26 Median $60.26 Typical High $63.10 | Facility | None | $60.26 | $60.26 | $63.10 |
Aetna Setting Professional Modifier None (both parts) Typical Low $60.26 Median $63.10 Typical High $109.65 | Professional | None (both parts) | $60.26 | $63.10 | $109.65 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $69.18 Median $104.71 Typical High $104.71 | Professional | None (both parts) | $69.18 | $104.71 | $104.71 |
BCBS Texas 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 |
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 $81.28 Median $87.10 Typical High $87.10 | Facility | None | $81.28 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None (both parts) Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None (both parts) | $63.10 | $63.10 | $87.10 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None (both parts) | $1,318.26 | $1,318.26 | $1,318.26 |
Moda Health Setting Facility Modifier None Typical Low $43.65 Median $75.86 Typical High $138.04 | Facility | None | $43.65 | $75.86 | $138.04 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $60.26 Median $63.10 Typical High $109.65 | Professional | None (both parts) | $60.26 | $63.10 | $109.65 |
Molina Setting Professional Modifier None (both parts) Typical Low $75.86 Median $75.86 Typical High $81.28 | Professional | None (both parts) | $75.86 | $75.86 | $81.28 |
Oscar Health Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Providence Setting Facility Modifier None Typical Low $57.54 Median $87.10 Typical High $138.04 | Facility | None | $57.54 | $87.10 | $138.04 |
Providence Setting Professional Modifier None (both parts) Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None (both parts) | $63.10 | $63.10 | $87.10 |
United Setting Facility Modifier None Typical Low $91.20 Median $120.23 Typical High $154.88 | Facility | None | $91.20 | $120.23 | $154.88 |
United Setting Professional Modifier None (both parts) Typical Low $52.48 Median $72.44 Typical High $97.72 | Professional | None (both parts) | $52.48 | $72.44 | $97.72 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None (both parts) | $85.11 | $85.11 | $85.11 |
11 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 $29.51 Median $31.62 Typical High $38.90 | Professional | 52 · Reduced service | $29.51 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.59 Typical High $15.49 | Professional | 53 · Discontinued | $11.75 | $12.59 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $11.75 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.31 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.89 | $6.31 | $7.76 |
Christus Setting Professional Modifier 26 · Professional part Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 26 · Professional part | $114.82 | $114.82 | $114.82 |
Cigna Setting Professional Modifier RR · Rental Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | RR · Rental | $8.71 | $8.71 | $8.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $31.62 Typical High $38.90 | Professional | 52 · Reduced service | $29.51 | $31.62 | $38.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $12.59 Typical High $15.49 | Professional | 53 · Discontinued | $11.75 | $12.59 | $15.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $11.75 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $11.75 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.31 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.89 | $6.31 | $7.76 |
Providence Setting Professional Modifier RR · Rental Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | RR · Rental | $8.71 | $8.71 | $8.71 |
Where Texas sits
The same service costs 5.0 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· 49th of 51
$69.18
HI $316DE $63.10
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.