How much rates vary
Facilitymedian $39 · 10th to 90th $32 to $79Professionalmedian $37 · 10th to 90th $28 to $589
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 $34.67 Median $34.67 Typical High $36.31 | Facility | None | $34.67 | $34.67 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $35.48 Typical High $41.69 | Professional | None | $33.11 | $35.48 | $41.69 |
BCBS Texas Setting Professional Modifier None Typical Low $37.15 Median $46.77 Typical High $46.77 | Professional | None | $37.15 | $46.77 | $46.77 |
Christus Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $38.90 | Professional | None | $28.18 | $28.18 | $38.90 |
Lucent Health Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $588.84 | Professional | None | $389.05 | $588.84 | $588.84 |
Moda Health Setting Facility Modifier None Typical Low $18.62 Median $43.65 Typical High $79.43 | Facility | None | $18.62 | $43.65 | $79.43 |
Moda Health Setting Professional Modifier None Typical Low $32.36 Median $36.31 Typical High $52.48 | Professional | None | $32.36 | $36.31 | $52.48 |
Molina Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $81.28 | Professional | None | $43.65 | $43.65 | $81.28 |
Providence Setting Facility Modifier None Typical Low $33.11 Median $38.90 Typical High $79.43 | Facility | None | $33.11 | $38.90 | $79.43 |
Providence Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $38.90 | Professional | None | $28.18 | $28.18 | $38.90 |
United Setting Facility Modifier None Typical Low $35.48 Median $38.02 Typical High $67.61 | Facility | None | $35.48 | $38.02 | $67.61 |
United Setting Professional Modifier None Typical Low $22.39 Median $32.36 Typical High $41.69 | Professional | None | $22.39 | $32.36 | $41.69 |
Wellpoint Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
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 $16.60 Median $18.20 Typical High $20.89 | Professional | 52 · Reduced service | $16.60 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $7.24 Typical High $8.32 | Professional | 53 · Discontinued | $6.61 | $7.24 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.37 Typical High $6.31 | Professional | 55 · Aftercare only | $5.01 | $5.37 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.63 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.31 | $3.63 | $4.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $17.78 Typical High $20.89 | Professional | 52 · Reduced service | $16.22 | $17.78 | $20.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $7.08 Typical High $8.32 | Professional | 53 · Discontinued | $6.46 | $7.08 | $8.32 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.37 Typical High $6.17 | Professional | 55 · Aftercare only | $4.90 | $5.37 | $6.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.55 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.24 | $3.55 | $4.17 |
Where Texas sits
The same service costs 3.0 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· 28th of 51
$38.90
HI $83.18DE $28.18
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.