How much rates vary
Facilitymedian $141 · 10th to 90th $100 to $240Professionalmedian $115 · 10th to 90th $102 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 $104.71 Median $104.71 Typical High $107.15 | Facility | None | $104.71 | $104.71 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $107.15 Typical High $134.90 | Professional | None | $102.33 | $107.15 | $134.90 |
BCBS Texas Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Christus Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
Lucent Health Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Moda Health Setting Facility Modifier None Typical Low $72.44 Median $131.83 Typical High $239.88 | Facility | None | $72.44 | $131.83 | $239.88 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $107.15 Typical High $151.36 | Professional | None | $102.33 | $107.15 | $151.36 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $131.83 Typical High $131.83 | Professional | None | $81.28 | $131.83 | $131.83 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $141.25 Typical High $239.88 | Facility | None | $100.00 | $141.25 | $239.88 |
Providence Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
United Setting Facility Modifier None Typical Low $151.36 Median $263.03 Typical High $389.05 | Facility | None | $151.36 | $263.03 | $389.05 |
United Setting Professional Modifier None Typical Low $87.10 Median $123.03 Typical High $162.18 | Professional | None | $87.10 | $123.03 | $162.18 |
Wellpoint Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
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 $51.29 Median $53.70 Typical High $67.61 | Professional | 52 · Reduced service | $51.29 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $21.88 Typical High $26.92 | Professional | 53 · Discontinued | $20.42 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.22 Typical High $20.42 | Professional | 55 · Aftercare only | $15.14 | $16.22 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.72 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.23 | $10.72 | $13.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $53.70 Typical High $67.61 | Professional | 52 · Reduced service | $51.29 | $53.70 | $67.61 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $21.88 Typical High $26.92 | Professional | 53 · Discontinued | $20.42 | $21.88 | $26.92 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.22 Typical High $19.95 | Professional | 55 · Aftercare only | $15.14 | $16.22 | $19.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.72 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.23 | $10.72 | $13.49 |
Where Texas sits
The same service costs 8.1 times more in Hawaii 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· 37th of 51
$132
HI $832DE $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.