How much rates vary
Facilitymedian $59 · 10th to 90th $41 to $126Professionalmedian $60 · 10th to 90th $43 to $851
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 $54.95 Median $54.95 Typical High $57.54 | Facility | None | $54.95 | $54.95 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $57.54 Typical High $67.61 | Professional | None | $53.70 | $57.54 | $67.61 |
BCBS Texas Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Christus Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $58.88 | Professional | None | $42.66 | $42.66 | $58.88 |
Lucent Health Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $851.14 | Professional | None | $630.96 | $851.14 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $30.20 Median $69.18 Typical High $125.89 | Facility | None | $30.20 | $69.18 | $125.89 |
Moda Health Setting Professional Modifier None Typical Low $52.48 Median $57.54 Typical High $75.86 | Professional | None | $52.48 | $57.54 | $75.86 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $81.28 | Professional | None | $70.79 | $70.79 | $81.28 |
Providence Setting Facility Modifier None Typical Low $53.70 Median $58.88 Typical High $125.89 | Facility | None | $53.70 | $58.88 | $125.89 |
Providence Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $58.88 | Professional | None | $42.66 | $42.66 | $58.88 |
United Setting Facility Modifier None Typical Low $40.74 Median $46.77 Typical High $109.65 | Facility | None | $40.74 | $46.77 | $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 $26.30 Median $28.84 Typical High $33.88 | Professional | 52 · Reduced service | $26.30 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $11.48 Typical High $13.49 | Professional | 53 · Discontinued | $10.72 | $11.48 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.71 Typical High $10.23 | Professional | 55 · Aftercare only | $7.94 | $8.71 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.75 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.37 | $5.75 | $6.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $28.18 Typical High $33.88 | Professional | 52 · Reduced service | $26.30 | $28.18 | $33.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $11.22 Typical High $13.49 | Professional | 53 · Discontinued | $10.47 | $11.22 | $13.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.51 Typical High $10.23 | Professional | 55 · Aftercare only | $7.94 | $8.51 | $10.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.62 Typical High $6.76 | Professional | 56 · Pre-op care only | $5.25 | $5.62 | $6.76 |
Where Texas sits
The same service costs 2.5 times more in Arkansas 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· 24th of 51
$60.26
AR $107DE $42.66
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.