How much rates vary
Facilitymedian $65 · 10th to 90th $50 to $132Professionalmedian $62 · 10th to 90th $47 to $794
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 $57.54 Median $57.54 Typical High $60.26 | Facility | None | $57.54 | $57.54 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $74.13 | Professional | None | $56.23 | $60.26 | $74.13 |
BCBS Texas Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $77.62 | Professional | None | $61.66 | $61.66 | $77.62 |
Christus Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
Lucent Health Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $794.33 | Professional | None | $645.65 | $794.33 | $794.33 |
Moda Health Setting Facility Modifier None Typical Low $33.11 Median $72.44 Typical High $131.83 | Facility | None | $33.11 | $72.44 | $131.83 |
Moda Health Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $81.28 | Professional | None | $54.95 | $60.26 | $81.28 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $81.28 | Professional | None | $66.07 | $66.07 | $81.28 |
Providence Setting Facility Modifier None Typical Low $54.95 Median $64.57 Typical High $131.83 | Facility | None | $54.95 | $64.57 | $131.83 |
Providence Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
United Setting Facility Modifier None Typical Low $50.12 Median $60.26 Typical High $120.23 | Facility | None | $50.12 | $60.26 | $120.23 |
United Setting Professional Modifier None Typical Low $39.81 Median $57.54 Typical High $74.13 | Professional | None | $39.81 | $57.54 | $74.13 |
Wellpoint Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $61.66 | Professional | None | $60.26 | $60.26 | $61.66 |
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 $28.18 Median $30.20 Typical High $37.15 | Professional | 52 · Reduced service | $28.18 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $12.02 Typical High $14.79 | Professional | 53 · Discontinued | $11.22 | $12.02 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.91 Typical High $11.22 | Professional | 55 · Aftercare only | $8.51 | $8.91 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.03 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.62 | $6.03 | $7.41 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $30.20 Typical High $35.48 | Professional | 52 · Reduced service | $28.18 | $30.20 | $35.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $12.02 Typical High $14.13 | Professional | 53 · Discontinued | $11.22 | $12.02 | $14.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.91 Typical High $10.72 | Professional | 55 · Aftercare only | $8.51 | $8.91 | $10.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.03 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.62 | $6.03 | $7.08 |
Where Texas sits
The same service costs 2.8 times more in Wisconsin 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· 31st of 51
$64.57
WI $132DE $46.77
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.