How much rates vary
Facilitymedian $89 · 10th to 90th $78 to $191Professionalmedian $85 · 10th to 90th $66 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 $83.18 Median $83.18 Typical High $85.11 | Facility | None | $83.18 | $83.18 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $85.11 Typical High $97.72 | Professional | None | $77.62 | $85.11 | $97.72 |
BCBS Texas Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $109.65 | Professional | None | $87.10 | $87.10 | $109.65 |
Christus Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $89.13 | Professional | None | $66.07 | $66.07 | $89.13 |
Lucent Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $44.67 Median $104.71 Typical High $190.55 | Facility | None | $44.67 | $104.71 | $190.55 |
Moda Health Setting Professional Modifier None Typical Low $77.62 Median $85.11 Typical High $125.89 | Professional | None | $77.62 | $85.11 | $125.89 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $104.71 Typical High $104.71 | Professional | None | $81.28 | $104.71 | $104.71 |
Providence Setting Facility Modifier None Typical Low $79.43 Median $89.13 Typical High $190.55 | Facility | None | $79.43 | $89.13 | $190.55 |
Providence Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $89.13 | Professional | None | $66.07 | $66.07 | $89.13 |
United Setting Facility Modifier None Typical Low $93.33 Median $114.82 Typical High $158.49 | Facility | None | $93.33 | $114.82 | $158.49 |
United Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $100.00 | Professional | None | $53.70 | $77.62 | $100.00 |
Wellpoint Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
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 $38.90 Median $41.69 Typical High $48.98 | Professional | 52 · Reduced service | $38.90 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $16.98 Typical High $19.95 | Professional | 53 · Discontinued | $15.49 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.59 Typical High $14.79 | Professional | 55 · Aftercare only | $11.75 | $12.59 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.32 Typical High $9.77 | Professional | 56 · Pre-op care only | $7.76 | $8.32 | $9.77 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $41.69 Typical High $48.98 | Professional | 52 · Reduced service | $38.90 | $41.69 | $48.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $16.98 Typical High $19.95 | Professional | 53 · Discontinued | $15.49 | $16.98 | $19.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.59 Typical High $14.79 | Professional | 55 · Aftercare only | $11.75 | $12.59 | $14.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.32 Typical High $9.77 | Professional | 56 · Pre-op care only | $7.76 | $8.32 | $9.77 |
Where Texas sits
The same service costs 5.1 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· 30th of 51
$87.10
HI $339DE $66.07
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.