How much rates vary
Facilitymedian $63 · 10th to 90th $48 to $112Professionalmedian $60 · 10th to 90th $46 to $832
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 $48.98 Median $48.98 Typical High $51.29 | Facility | None | $48.98 | $48.98 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $51.29 Typical High $87.10 | Professional | None | $47.86 | $51.29 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $47.86 Median $85.11 Typical High $85.11 | Professional | None | $47.86 | $85.11 | $85.11 |
BCBS Texas Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $66.07 | Professional | None | $52.48 | $52.48 | $66.07 |
Christus Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $63.10 Typical High $63.10 | Facility | None | $56.23 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Lucent Health Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $831.76 | Professional | None | $724.44 | $831.76 | $831.76 |
Moda Health Setting Facility Modifier None Typical Low $30.90 Median $61.66 Typical High $112.20 | Facility | None | $30.90 | $61.66 | $112.20 |
Moda Health Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $89.13 | Professional | None | $46.77 | $51.29 | $89.13 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $81.28 | Professional | None | $67.61 | $67.61 | $81.28 |
Providence Setting Facility Modifier None Typical Low $47.86 Median $63.10 Typical High $112.20 | Facility | None | $47.86 | $63.10 | $112.20 |
Providence Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
United Setting Facility Modifier None Typical Low $60.26 Median $63.10 Typical High $109.65 | Facility | None | $60.26 | $63.10 | $109.65 |
United Setting Professional Modifier None Typical Low $37.15 Median $52.48 Typical High $69.18 | Professional | None | $37.15 | $52.48 | $69.18 |
Wellpoint Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
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 $23.99 Median $25.70 Typical High $30.90 | Professional | 52 · Reduced service | $23.99 | $25.70 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $10.23 Typical High $12.30 | Professional | 53 · Discontinued | $9.55 | $10.23 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.76 Typical High $9.33 | Professional | 55 · Aftercare only | $7.24 | $7.76 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.13 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.79 | $5.13 | $6.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $25.70 Typical High $30.90 | Professional | 52 · Reduced service | $23.99 | $25.70 | $30.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $10.23 Typical High $12.30 | Professional | 53 · Discontinued | $9.55 | $10.23 | $12.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.76 Typical High $9.12 | Professional | 55 · Aftercare only | $7.24 | $7.76 | $9.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.13 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.79 | $5.13 | $6.17 |
Where Texas sits
The same service costs 3.8 times more in Hawaii 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· 33rd of 51
$60.26
HI $174FL $45.71
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.