How much rates vary
Facilitymedian $110 · 10th to 90th $89 to $240Professionalmedian $110 · 10th to 90th $81 to $1,698
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 $104.71 Median $104.71 Typical High $109.65 | Facility | None | $104.71 | $104.71 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $125.89 | Professional | None | $97.72 | $109.65 | $125.89 |
BCBS Texas Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Christus Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $109.65 | Professional | None | $81.28 | $81.28 | $109.65 |
Lucent Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,698.24 | $1,698.24 |
Moda Health Setting Facility Modifier None Typical Low $56.23 Median $131.83 Typical High $239.88 | Facility | None | $56.23 | $131.83 | $239.88 |
Moda Health Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $138.04 | Professional | None | $97.72 | $109.65 | $138.04 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $134.90 | Professional | None | $81.28 | $134.90 | $134.90 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $109.65 Typical High $239.88 | Facility | None | $100.00 | $109.65 | $239.88 |
Providence Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $109.65 | Professional | None | $81.28 | $81.28 | $109.65 |
United Setting Facility Modifier None Typical Low $89.13 Median $107.15 Typical High $204.17 | Facility | None | $89.13 | $107.15 | $204.17 |
United Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $125.89 | Professional | None | $67.61 | $97.72 | $125.89 |
Wellpoint Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
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 $48.98 Median $54.95 Typical High $63.10 | Professional | 52 · Reduced service | $48.98 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $21.88 Typical High $25.12 | Professional | 53 · Discontinued | $19.95 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.22 Typical High $19.05 | Professional | 55 · Aftercare only | $14.79 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.96 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.77 | $10.96 | $12.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $53.70 Typical High $63.10 | Professional | 52 · Reduced service | $48.98 | $53.70 | $63.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $21.38 Typical High $25.12 | Professional | 53 · Discontinued | $19.95 | $21.38 | $25.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.22 Typical High $18.62 | Professional | 55 · Aftercare only | $14.79 | $16.22 | $18.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.72 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.77 | $10.72 | $12.59 |
Where Texas sits
The same service costs 3.0 times more in Montana 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· 23rd of 51
$110
MT $240DE $81.28
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.