How much rates vary
Facilitymedian $65 · 10th to 90th $49 to $100Professionalmedian $52 · 10th to 90th $45 to $1,072
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 $43.65 Median $43.65 Typical High $45.71 | Facility | None | $43.65 | $43.65 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $45.71 Typical High $79.43 | Professional | None | $43.65 | $45.71 | $79.43 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $89.13 | Professional | None | $74.13 | $74.13 | $89.13 |
BCBS Texas Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $58.88 | Professional | None | $46.77 | $46.77 | $58.88 |
Christus Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $72.44 | Professional | None | $52.48 | $52.48 | $72.44 |
Health Smart Setting Professional Modifier None Typical Low $54.95 Median $104.71 Typical High $120.23 | Professional | None | $54.95 | $104.71 | $120.23 |
Lucent Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Moda Health Setting Facility Modifier None Typical Low $31.62 Median $54.95 Typical High $100.00 | Facility | None | $31.62 | $54.95 | $100.00 |
Moda Health Setting Professional Modifier None Typical Low $43.65 Median $45.71 Typical High $79.43 | Professional | None | $43.65 | $45.71 | $79.43 |
Molina Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $81.28 | Professional | None | $52.48 | $52.48 | $81.28 |
Providence Setting Facility Modifier None Typical Low $41.69 Median $72.44 Typical High $100.00 | Facility | None | $41.69 | $72.44 | $100.00 |
Providence Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $72.44 | Professional | None | $52.48 | $52.48 | $72.44 |
United Setting Facility Modifier None Typical Low $64.57 Median $100.00 Typical High $112.20 | Facility | None | $64.57 | $100.00 | $112.20 |
United Setting Professional Modifier None Typical Low $38.02 Median $52.48 Typical High $70.79 | Professional | None | $38.02 | $52.48 | $70.79 |
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 $21.38 Median $22.91 Typical High $28.18 | Professional | 52 · Reduced service | $21.38 | $22.91 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $9.12 Typical High $11.22 | Professional | 53 · Discontinued | $8.51 | $9.12 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.76 Typical High $8.51 | Professional | 55 · Aftercare only | $6.46 | $6.76 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.57 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.27 | $4.57 | $5.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $22.91 Typical High $28.18 | Professional | 52 · Reduced service | $21.38 | $22.91 | $28.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $9.12 Typical High $11.22 | Professional | 53 · Discontinued | $8.51 | $9.12 | $11.22 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.76 Typical High $8.51 | Professional | 55 · Aftercare only | $6.46 | $6.76 | $8.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.57 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.27 | $4.57 | $5.62 |
Where Texas sits
The same service costs 5.0 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· 48th of 51
$52.48
HI $257FL $51.29
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.