How much rates vary
Facilitymedian $126 · 10th to 90th $78 to $145Professionalmedian $87 · 10th to 90th $65 to $1,175
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 $70.79 Median $70.79 Typical High $74.13 | Facility | None | $70.79 | $70.79 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $74.13 Typical High $91.20 | Professional | None | $69.18 | $74.13 | $91.20 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
BCBS Texas Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $93.33 | Professional | None | $75.86 | $75.86 | $93.33 |
Baylor Scott & White Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $162.18 | Professional | None | $120.23 | $120.23 | $162.18 |
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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | None | $64.57 | $64.57 | $89.13 |
Lucent Health Setting Professional Modifier None Typical Low $812.83 Median $1,174.90 Typical High $1,174.90 | Professional | None | $812.83 | $1,174.90 | $1,174.90 |
Moda Health Setting Facility Modifier None Typical Low $45.71 Median $89.13 Typical High $162.18 | Facility | None | $45.71 | $89.13 | $162.18 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $74.13 Typical High $104.71 | Professional | None | $69.18 | $74.13 | $104.71 |
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 $67.61 Median $89.13 Typical High $162.18 | Facility | None | $67.61 | $89.13 | $162.18 |
Providence Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | None | $64.57 | $64.57 | $89.13 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $190.55 | Facility | None | $77.62 | $77.62 | $190.55 |
United Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $100.00 | Professional | None | $53.70 | $77.62 | $100.00 |
Wellpoint Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
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 $34.67 Median $37.15 Typical High $45.71 | Professional | 52 · Reduced service | $34.67 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.79 Typical High $18.20 | Professional | 53 · Discontinued | $13.80 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.96 Typical High $13.49 | Professional | 55 · Aftercare only | $10.47 | $10.96 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.41 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.92 | $7.41 | $9.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $37.15 Typical High $43.65 | Professional | 52 · Reduced service | $34.67 | $37.15 | $43.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.79 Typical High $17.78 | Professional | 53 · Discontinued | $13.80 | $14.79 | $17.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.96 Typical High $13.18 | Professional | 55 · Aftercare only | $10.47 | $10.96 | $13.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.41 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.92 | $7.41 | $8.71 |
Where Texas sits
The same service costs 2.8 times more in Kansas 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· 27th of 51
$89.13
KS $178DE $64.57
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.