How much rates vary
Facilitymedian $120 · 10th to 90th $72 to $174Professionalmedian $100 · 10th to 90th $76 to $1,413
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 $75.86 Median $75.86 Typical High $79.43 | Facility | None | $75.86 | $75.86 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $79.43 Typical High $100.00 | Professional | None | $74.13 | $79.43 | $100.00 |
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 $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | None | $87.10 | $87.10 | $120.23 |
Lucent Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,412.54 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $54.95 Median $95.50 Typical High $173.78 | Facility | None | $54.95 | $95.50 | $173.78 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $79.43 Typical High $131.83 | Professional | None | $74.13 | $79.43 | $131.83 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $91.20 Typical High $91.20 | Professional | None | $81.28 | $91.20 | $91.20 |
Providence Setting Facility Modifier None Typical Low $72.44 Median $120.23 Typical High $173.78 | Facility | None | $72.44 | $120.23 | $173.78 |
Providence Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | None | $87.10 | $87.10 | $120.23 |
United Setting Facility Modifier None Typical Low $72.44 Median $85.11 Typical High $194.98 | Facility | None | $72.44 | $85.11 | $194.98 |
United Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $120.23 | Professional | None | $64.57 | $93.33 | $120.23 |
Wellpoint Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $102.33 | Professional | None | $100.00 | $100.00 | $102.33 |
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 $39.81 Typical High $50.12 | Professional | 52 · Reduced service | $37.15 | $39.81 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $15.85 Typical High $19.95 | Professional | 53 · Discontinued | $14.79 | $15.85 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.75 Typical High $14.79 | Professional | 55 · Aftercare only | $11.22 | $11.75 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.94 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.41 | $7.94 | $10.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $39.81 Typical High $48.98 | Professional | 52 · Reduced service | $37.15 | $39.81 | $48.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $15.85 Typical High $19.50 | Professional | 53 · Discontinued | $14.79 | $15.85 | $19.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.75 Typical High $14.79 | Professional | 55 · Aftercare only | $11.22 | $11.75 | $14.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.94 Typical High $9.77 | Professional | 56 · Pre-op care only | $7.41 | $7.94 | $9.77 |
Where Texas sits
The same service costs 2.4 times more in Montana than in Vermont. 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· 36th of 51
$100
MT $209VT $87.10
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.