How much rates vary
Facilitymedian $145 · 10th to 90th $95 to $148Professionalmedian $93 · 10th to 90th $71 to $1,148
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 $87.10 Median $87.10 Typical High $91.20 | Facility | None | $87.10 | $87.10 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $91.20 Typical High $100.00 | Professional | None | $85.11 | $91.20 | $100.00 |
BCBS Texas Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $114.82 | Professional | None | $93.33 | $93.33 | $114.82 |
Christus Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None | $70.79 | $70.79 | $97.72 |
Lucent Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,023.29 | $1,148.15 | $1,148.15 |
Moda Health Setting Facility Modifier None Typical Low $48.98 Median $109.65 Typical High $199.53 | Facility | None | $48.98 | $109.65 | $199.53 |
Moda Health Setting Professional Modifier None Typical Low $85.11 Median $91.20 Typical High $112.20 | Professional | None | $85.11 | $91.20 | $112.20 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $97.72 | Professional | None | $81.28 | $97.72 | $97.72 |
Providence Setting Facility Modifier None Typical Low $83.18 Median $97.72 Typical High $199.53 | Facility | None | $83.18 | $97.72 | $199.53 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None | $70.79 | $70.79 | $97.72 |
United Setting Facility Modifier None Typical Low $95.50 Median $100.00 Typical High $173.78 | Facility | None | $95.50 | $100.00 | $173.78 |
United Setting Professional Modifier None Typical Low $57.54 Median $83.18 Typical High $107.15 | Professional | None | $57.54 | $83.18 | $107.15 |
Wellpoint Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
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 $42.66 Median $45.71 Typical High $52.48 | Professional | 52 · Reduced service | $42.66 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.20 Typical High $20.89 | Professional | 53 · Discontinued | $16.98 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.49 Typical High $15.49 | Professional | 55 · Aftercare only | $12.59 | $13.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.12 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.51 | $9.12 | $10.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $44.67 Typical High $52.48 | Professional | 52 · Reduced service | $41.69 | $44.67 | $52.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $17.78 Typical High $20.89 | Professional | 53 · Discontinued | $16.60 | $17.78 | $20.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.18 Typical High $15.49 | Professional | 55 · Aftercare only | $12.59 | $13.18 | $15.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.91 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.32 | $8.91 | $10.47 |
Where Texas sits
The same service costs 3.2 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· 29th of 51
$95.50
HI $224FL $70.79
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.