How much rates vary
Facilitymedian $129 · 10th to 90th $81 to $158Professionalmedian $98 · 10th to 90th $78 to $1,288
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 $77.62 Median $77.62 Typical High $81.28 | Facility | None | $77.62 | $77.62 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $100.00 | Professional | None | $75.86 | $81.28 | $100.00 |
BCBS Texas Setting Professional Modifier None Typical Low $83.18 Median $134.90 Typical High $134.90 | Professional | None | $83.18 | $134.90 | $134.90 |
Christus Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None | $85.11 | $85.11 | $117.49 |
Lucent Health Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $891.25 | $1,288.25 | $1,288.25 |
Moda Health Setting Facility Modifier None Typical Low $50.12 Median $97.72 Typical High $177.83 | Facility | None | $50.12 | $97.72 | $177.83 |
Moda Health Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $114.82 | Professional | None | $75.86 | $81.28 | $114.82 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $109.65 | Professional | None | $81.28 | $109.65 | $109.65 |
Providence Setting Facility Modifier None Typical Low $74.13 Median $117.49 Typical High $177.83 | Facility | None | $74.13 | $117.49 | $177.83 |
Providence Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None | $85.11 | $85.11 | $117.49 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $208.93 | Facility | None | $57.54 | $57.54 | $208.93 |
United Setting Professional Modifier None Typical Low $58.88 Median $85.11 Typical High $109.65 | Professional | None | $58.88 | $85.11 | $109.65 |
Wellpoint Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
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 $38.02 Median $40.74 Typical High $50.12 | Professional | 52 · Reduced service | $38.02 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $16.22 Typical High $19.95 | Professional | 53 · Discontinued | $15.14 | $16.22 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.02 Typical High $14.79 | Professional | 55 · Aftercare only | $11.48 | $12.02 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.13 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.59 | $8.13 | $10.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $40.74 Typical High $47.86 | Professional | 52 · Reduced service | $38.02 | $40.74 | $47.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $16.22 Typical High $19.50 | Professional | 53 · Discontinued | $15.14 | $16.22 | $19.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.02 Typical High $14.45 | Professional | 55 · Aftercare only | $11.48 | $12.02 | $14.45 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.13 Typical High $9.55 | Professional | 56 · Pre-op care only | $7.59 | $8.13 | $9.55 |
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· 23rd of 51
$110
MT $178FL $85.11
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.