How much rates vary
Facilitymedian $81 · 10th to 90th $41 to $95Professionalmedian $59 · 10th to 90th $42 to $912
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 $41.69 Median $41.69 Typical High $43.65 | Facility | None | $41.69 | $41.69 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $43.65 Typical High $54.95 | Professional | None | $41.69 | $43.65 | $54.95 |
BCBS Texas Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Christus Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None | $58.88 | $58.88 | $81.28 |
Lucent Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
Moda Health Setting Facility Modifier None Typical Low $30.20 Median $52.48 Typical High $95.50 | Facility | None | $30.20 | $52.48 | $95.50 |
Moda Health Setting Professional Modifier None Typical Low $41.69 Median $43.65 Typical High $64.57 | Professional | None | $41.69 | $43.65 | $64.57 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $81.28 | Professional | None | $53.70 | $53.70 | $81.28 |
Providence Setting Facility Modifier None Typical Low $40.74 Median $81.28 Typical High $95.50 | Facility | None | $40.74 | $81.28 | $95.50 |
Providence Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None | $58.88 | $58.88 | $81.28 |
United Setting Facility Modifier None Typical Low $63.10 Median $93.33 Typical High $109.65 | Facility | None | $63.10 | $93.33 | $109.65 |
United Setting Professional Modifier None Typical Low $36.31 Median $50.12 Typical High $67.61 | Professional | None | $36.31 | $50.12 | $67.61 |
Wellpoint Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
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 $20.42 Median $21.88 Typical High $27.54 | Professional | 52 · Reduced service | $20.42 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.71 Typical High $10.96 | Professional | 53 · Discontinued | $8.32 | $8.71 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.61 Typical High $8.32 | Professional | 55 · Aftercare only | $6.17 | $6.61 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.37 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.17 | $4.37 | $5.50 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $21.88 Typical High $27.54 | Professional | 52 · Reduced service | $20.42 | $21.88 | $27.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.71 Typical High $10.96 | Professional | 53 · Discontinued | $8.32 | $8.71 | $10.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.61 Typical High $8.13 | Professional | 55 · Aftercare only | $6.17 | $6.61 | $8.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.37 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.17 | $4.37 | $5.50 |
Where Texas sits
The same service costs 4.4 times more in Hawaii than in Florida. 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· 43rd of 51
$58.88
HI $219FL $50.12
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.