How much rates vary
Facilitymedian $54 · 10th to 90th $33 to $78Professionalmedian $46 · 10th to 90th $35 to $708
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 $33.88 Median $33.88 Typical High $35.48 | Facility | None | $33.88 | $33.88 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $35.48 Typical High $61.66 | Professional | None | $33.11 | $35.48 | $61.66 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
BCBS Texas Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $45.71 | Professional | None | $36.31 | $36.31 | $45.71 |
Christus Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $53.70 | Professional | None | $39.81 | $39.81 | $53.70 |
Lucent Health Setting Professional Modifier None Typical Low $512.86 Median $707.95 Typical High $707.95 | Professional | None | $512.86 | $707.95 | $707.95 |
Moda Health Setting Facility Modifier None Typical Low $24.55 Median $42.66 Typical High $77.62 | Facility | None | $24.55 | $42.66 | $77.62 |
Moda Health Setting Professional Modifier None Typical Low $33.11 Median $35.48 Typical High $61.66 | Professional | None | $33.11 | $35.48 | $61.66 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $81.28 | Professional | None | $39.81 | $39.81 | $81.28 |
Providence Setting Facility Modifier None Typical Low $33.11 Median $53.70 Typical High $77.62 | Facility | None | $33.11 | $53.70 | $77.62 |
Providence Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $53.70 | Professional | None | $39.81 | $39.81 | $53.70 |
United Setting Facility Modifier None Typical Low $47.86 Median $51.29 Typical High $89.13 | Facility | None | $47.86 | $51.29 | $89.13 |
United Setting Professional Modifier None Typical Low $29.51 Median $40.74 Typical High $54.95 | Professional | None | $29.51 | $40.74 | $54.95 |
Wellpoint Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
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 $16.60 Median $17.78 Typical High $21.88 | Professional | 52 · Reduced service | $16.60 | $17.78 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $7.08 Typical High $8.71 | Professional | 53 · Discontinued | $6.61 | $7.08 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.37 Typical High $6.61 | Professional | 55 · Aftercare only | $5.01 | $5.37 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.55 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.31 | $3.55 | $4.37 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.60 Median $17.78 Typical High $21.88 | Professional | 52 · Reduced service | $16.60 | $17.78 | $21.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $7.08 Typical High $8.71 | Professional | 53 · Discontinued | $6.61 | $7.08 | $8.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.37 Typical High $6.61 | Professional | 55 · Aftercare only | $5.01 | $5.37 | $6.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.55 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.31 | $3.55 | $4.37 |
Where Texas sits
The same service costs 3.1 times more in Hawaii than in West Virginia. 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· 39th of 51
$45.71
HI $123WV $39.81
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.