How much rates vary
Facilitymedian $219 · 10th to 90th $110 to $398Professionalmedian $214 · 10th to 90th $158 to $3,467
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 $177.83 Median $177.83 Typical High $181.97 | Facility | None | $177.83 | $177.83 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $181.97 Typical High $223.87 | Professional | None | $173.78 | $181.97 | $223.87 |
BCBS Texas Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Christus Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Lucent Health Setting Professional Modifier None Typical Low $2,187.76 Median $3,467.37 Typical High $3,467.37 | Professional | None | $2,187.76 | $3,467.37 | $3,467.37 |
Moda Health Setting Facility Modifier None Typical Low $109.65 Median $223.87 Typical High $398.11 | Facility | None | $109.65 | $223.87 | $398.11 |
Moda Health Setting Professional Modifier None Typical Low $173.78 Median $181.97 Typical High $245.47 | Professional | None | $173.78 | $181.97 | $245.47 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $223.87 Typical High $223.87 | Professional | None | $81.28 | $223.87 | $223.87 |
Providence Setting Facility Modifier None Typical Low $169.82 Median $218.78 Typical High $398.11 | Facility | None | $169.82 | $218.78 | $398.11 |
Providence Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
United Setting Facility Modifier None Typical Low $36.31 Median $169.82 Typical High $389.05 | Facility | None | $36.31 | $169.82 | $389.05 |
United Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $239.88 | Professional | None | $128.82 | $190.55 | $239.88 |
Wellpoint Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
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 $87.10 Median $91.20 Typical High $112.20 | Professional | 52 · Reduced service | $87.10 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $36.31 Typical High $45.71 | Professional | 53 · Discontinued | $34.67 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $27.54 Typical High $33.88 | Professional | 55 · Aftercare only | $25.70 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $18.20 Typical High $22.39 | Professional | 56 · Pre-op care only | $17.38 | $18.20 | $22.39 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $91.20 Typical High $109.65 | Professional | 52 · Reduced service | $87.10 | $91.20 | $109.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $36.31 Typical High $43.65 | Professional | 53 · Discontinued | $34.67 | $36.31 | $43.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $27.54 Typical High $33.11 | Professional | 55 · Aftercare only | $25.70 | $27.54 | $33.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $18.20 Typical High $21.88 | Professional | 56 · Pre-op care only | $17.38 | $18.20 | $21.88 |
Where Texas sits
The same service costs 3.6 times more in Georgia than in Alaska. 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· 30th of 51
$214
GA $372AK $102
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.