How much rates vary
Facilitymedian $145 · 10th to 90th $85 to $204Professionalmedian $120 · 10th to 90th $89 to $1,514
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 $89.13 Median $89.13 Typical High $93.33 | Facility | None | $89.13 | $89.13 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $93.33 Typical High $117.49 | Professional | None | $87.10 | $93.33 | $117.49 |
BCBS Texas Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Christus Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | None | $104.71 | $104.71 | $144.54 |
Lucent Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,318.26 | $1,513.56 | $1,513.56 |
Moda Health Setting Facility Modifier None Typical Low $64.57 Median $112.20 Typical High $204.17 | Facility | None | $64.57 | $112.20 | $204.17 |
Moda Health Setting Professional Modifier None Typical Low $87.10 Median $93.33 Typical High $154.88 | Professional | None | $87.10 | $93.33 | $154.88 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $102.33 | Professional | None | $81.28 | $102.33 | $102.33 |
Providence Setting Facility Modifier None Typical Low $85.11 Median $144.54 Typical High $204.17 | Facility | None | $85.11 | $144.54 | $204.17 |
Providence Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $144.54 | Professional | None | $104.71 | $104.71 | $144.54 |
United Setting Facility Modifier None Typical Low $87.10 Median $100.00 Typical High $229.09 | Facility | None | $87.10 | $100.00 | $229.09 |
United Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $144.54 | Professional | None | $77.62 | $107.15 | $144.54 |
Wellpoint Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
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 $43.65 Median $46.77 Typical High $58.88 | Professional | 52 · Reduced service | $43.65 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $18.62 Typical High $23.44 | Professional | 53 · Discontinued | $17.38 | $18.62 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.80 Typical High $17.78 | Professional | 55 · Aftercare only | $13.18 | $13.80 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.33 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.71 | $9.33 | $11.75 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $46.77 Typical High $57.54 | Professional | 52 · Reduced service | $43.65 | $46.77 | $57.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $18.62 Typical High $22.91 | Professional | 53 · Discontinued | $17.38 | $18.62 | $22.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.80 Typical High $17.38 | Professional | 55 · Aftercare only | $13.18 | $13.80 | $17.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.33 Typical High $11.48 | Professional | 56 · Pre-op care only | $8.71 | $9.33 | $11.48 |
Where Texas sits
The same service costs 2.5 times more in Montana 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· 42nd of 51
$120
MT $263FL $105
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.