How much rates vary
Facilitymedian $68 · 10th to 90th $32 to $107Professionalmedian $58 · 10th to 90th $47 to $776
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 $46.77 Median $46.77 Typical High $48.98 | Facility | None | $46.77 | $46.77 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $48.98 Typical High $60.26 | Professional | None | $46.77 | $48.98 | $60.26 |
BCBS Texas Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $85.11 | Professional | None | $50.12 | $50.12 | $85.11 |
Christus Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Lucent Health Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $776.25 | Professional | None | $537.03 | $776.25 | $776.25 |
Moda Health Setting Facility Modifier None Typical Low $30.20 Median $58.88 Typical High $107.15 | Facility | None | $30.20 | $58.88 | $107.15 |
Moda Health Setting Professional Modifier None Typical Low $46.77 Median $48.98 Typical High $69.18 | Professional | None | $46.77 | $48.98 | $69.18 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $81.28 | Professional | None | $66.07 | $66.07 | $81.28 |
Providence Setting Facility Modifier None Typical Low $45.71 Median $67.61 Typical High $107.15 | Facility | None | $45.71 | $67.61 | $107.15 |
Providence Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
United Setting Facility Modifier None Typical Low $32.36 Median $60.26 Typical High $109.65 | Facility | None | $32.36 | $60.26 | $109.65 |
United Setting Professional Modifier None Typical Low $36.31 Median $52.48 Typical High $67.61 | Professional | None | $36.31 | $52.48 | $67.61 |
Wellpoint Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
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 $22.91 Median $24.55 Typical High $30.20 | Professional | 52 · Reduced service | $22.91 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.77 Typical High $12.02 | Professional | 53 · Discontinued | $9.33 | $9.77 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.41 Typical High $9.12 | Professional | 55 · Aftercare only | $6.92 | $7.41 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.90 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.57 | $4.90 | $6.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $24.55 Typical High $29.51 | Professional | 52 · Reduced service | $22.91 | $24.55 | $29.51 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.77 Typical High $11.75 | Professional | 53 · Discontinued | $9.33 | $9.77 | $11.75 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.41 Typical High $8.71 | Professional | 55 · Aftercare only | $6.92 | $7.41 | $8.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.90 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.57 | $4.90 | $5.89 |
Where Texas sits
The same service costs 2.1 times more in Montana 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· 28th of 51
$58.88
MT $107FL $50.12
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.