How much rates vary
Facilitymedian $158 · 10th to 90th $110 to $263Professionalmedian $151 · 10th to 90th $115 to $1,950
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 $114.82 Median $114.82 Typical High $117.49 | Facility | None | $114.82 | $114.82 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $151.36 | Professional | None | $112.20 | $117.49 | $151.36 |
BCBS Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Christus Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
Lucent Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,905.46 | $1,949.84 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $83.18 Median $144.54 Typical High $263.03 | Facility | None | $83.18 | $144.54 | $263.03 |
Moda Health Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $190.55 | Professional | None | $112.20 | $117.49 | $190.55 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $138.04 Typical High $138.04 | Professional | None | $81.28 | $138.04 | $138.04 |
Providence Setting Facility Modifier None Typical Low $109.65 Median $158.49 Typical High $263.03 | Facility | None | $109.65 | $158.49 | $263.03 |
Providence Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
United Setting Facility Modifier None Typical Low $141.25 Median $169.82 Typical High $295.12 | Facility | None | $141.25 | $169.82 | $295.12 |
United Setting Professional Modifier None Typical Low $97.72 Median $138.04 Typical High $181.97 | Professional | None | $97.72 | $138.04 | $181.97 |
Wellpoint Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
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 $56.23 Median $58.88 Typical High $75.86 | Professional | 52 · Reduced service | $56.23 | $58.88 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $23.99 Typical High $30.20 | Professional | 53 · Discontinued | $22.39 | $23.99 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.78 Typical High $22.39 | Professional | 55 · Aftercare only | $16.98 | $17.78 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.75 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.22 | $11.75 | $15.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $58.88 Typical High $74.13 | Professional | 52 · Reduced service | $56.23 | $58.88 | $74.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $23.99 Typical High $29.51 | Professional | 53 · Discontinued | $22.39 | $23.99 | $29.51 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.78 Typical High $22.39 | Professional | 55 · Aftercare only | $16.98 | $17.78 | $22.39 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.75 Typical High $14.79 | Professional | 56 · Pre-op care only | $11.22 | $11.75 | $14.79 |
Where Texas sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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
$155
HI $468KS $107
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.