How much rates vary
Facilitymedian $91 · 10th to 90th $45 to $170Professionalmedian $85 · 10th to 90th $66 to $1,072
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 $74.13 Median $74.13 Typical High $77.62 | Facility | None | $74.13 | $74.13 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $77.62 Typical High $93.33 | Professional | None | $74.13 | $77.62 | $93.33 |
BCBS Texas Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Christus Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $91.20 | Professional | None | $66.07 | $66.07 | $91.20 |
Lucent Health Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,071.52 | Professional | None | $851.14 | $1,071.52 | $1,071.52 |
Moda Health Setting Facility Modifier None Typical Low $44.67 Median $95.50 Typical High $169.82 | Facility | None | $44.67 | $95.50 | $169.82 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $77.62 Typical High $97.72 | Professional | None | $74.13 | $77.62 | $97.72 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $83.18 Typical High $83.18 | Professional | None | $81.28 | $83.18 | $83.18 |
Providence Setting Facility Modifier None Typical Low $72.44 Median $91.20 Typical High $169.82 | Facility | None | $72.44 | $91.20 | $169.82 |
Providence Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $91.20 | Professional | None | $66.07 | $66.07 | $91.20 |
United Setting Facility Modifier None Typical Low $39.81 Median $69.18 Typical High $162.18 | Facility | None | $39.81 | $69.18 | $162.18 |
United Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $100.00 | Professional | None | $53.70 | $77.62 | $100.00 |
Wellpoint Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $83.18 | Professional | None | $81.28 | $81.28 | $83.18 |
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 $37.15 Median $38.90 Typical High $46.77 | Professional | 52 · Reduced service | $37.15 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $15.49 Typical High $18.62 | Professional | 53 · Discontinued | $14.79 | $15.49 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $11.75 Typical High $14.13 | Professional | 55 · Aftercare only | $10.96 | $11.75 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.76 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.41 | $7.76 | $9.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $38.90 Typical High $45.71 | Professional | 52 · Reduced service | $37.15 | $38.90 | $45.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $15.49 Typical High $18.62 | Professional | 53 · Discontinued | $14.79 | $15.49 | $18.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $11.75 Typical High $13.80 | Professional | 55 · Aftercare only | $10.96 | $11.75 | $13.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.76 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.41 | $7.76 | $9.12 |
Where Texas sits
The same service costs 2.5 times more in Montana 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
$87.10
MT $162DE $66.07
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.