How much rates vary
Facilitymedian $62 · 10th to 90th $32 to $115Professionalmedian $60 · 10th to 90th $45 to $813
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 $50.12 Median $50.12 Typical High $52.48 | Facility | None | $50.12 | $50.12 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $52.48 Typical High $64.57 | Professional | None | $48.98 | $52.48 | $64.57 |
BCBS Texas Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Christus Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Lucent Health Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $812.83 | Professional | None | $575.44 | $812.83 | $812.83 |
Moda Health Setting Facility Modifier None Typical Low $31.62 Median $63.10 Typical High $114.82 | Facility | None | $31.62 | $63.10 | $114.82 |
Moda Health Setting Professional Modifier None Typical Low $48.98 Median $52.48 Typical High $69.18 | Professional | None | $48.98 | $52.48 | $69.18 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $81.28 | Professional | None | $60.26 | $60.26 | $81.28 |
Providence Setting Facility Modifier None Typical Low $48.98 Median $61.66 Typical High $114.82 | Facility | None | $48.98 | $61.66 | $114.82 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
United Setting Facility Modifier None Typical Low $29.51 Median $48.98 Typical High $114.82 | Facility | None | $29.51 | $48.98 | $114.82 |
United Setting Professional Modifier None Typical Low $38.02 Median $54.95 Typical High $70.79 | Professional | None | $38.02 | $54.95 | $70.79 |
Wellpoint Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
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 $24.55 Median $26.30 Typical High $32.36 | Professional | 52 · Reduced service | $24.55 | $26.30 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.47 Typical High $12.88 | Professional | 53 · Discontinued | $9.77 | $10.47 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.76 Typical High $9.77 | Professional | 55 · Aftercare only | $7.41 | $7.76 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.25 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.90 | $5.25 | $6.46 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $26.30 Typical High $31.62 | Professional | 52 · Reduced service | $24.55 | $26.30 | $31.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.47 Typical High $12.59 | Professional | 53 · Discontinued | $9.77 | $10.47 | $12.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.76 Typical High $9.33 | Professional | 55 · Aftercare only | $7.41 | $7.76 | $9.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.25 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.90 | $5.25 | $6.31 |
Where Texas sits
The same service costs 2.4 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· 33rd of 51
$60.26
MT $107DE $44.67
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.