How much rates vary
Facilitymedian $69 · 10th to 90th $46 to $107Professionalmedian $58 · 10th to 90th $48 to $1,000
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 $46.77 Median $46.77 Typical High $48.98 | Facility | None | $46.77 | $46.77 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $48.98 Typical High $79.43 | Professional | None | $46.77 | $48.98 | $79.43 |
BCBS Texas Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $85.11 | Professional | None | $50.12 | $50.12 | $85.11 |
Christus Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $69.18 | Professional | None | $50.12 | $50.12 | $69.18 |
Lucent Health Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,000.00 | Professional | None | $912.01 | $1,000.00 | $1,000.00 |
Moda Health Setting Facility Modifier None Typical Low $33.88 Median $60.26 Typical High $107.15 | Facility | None | $33.88 | $60.26 | $107.15 |
Moda Health Setting Professional Modifier None Typical Low $46.77 Median $48.98 Typical High $91.20 | Professional | None | $46.77 | $48.98 | $91.20 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $81.28 | Professional | None | $57.54 | $57.54 | $81.28 |
Providence Setting Facility Modifier None Typical Low $45.71 Median $69.18 Typical High $107.15 | Facility | None | $45.71 | $69.18 | $107.15 |
Providence Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $69.18 | Professional | None | $50.12 | $50.12 | $69.18 |
United Setting Facility Modifier None Typical Low $70.79 Median $83.18 Typical High $123.03 | Facility | None | $70.79 | $83.18 | $123.03 |
United Setting Professional Modifier None Typical Low $40.74 Median $56.23 Typical High $75.86 | Professional | None | $40.74 | $56.23 | $75.86 |
Wellpoint Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
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 $22.91 Median $24.55 Typical High $30.90 | Professional | 52 · Reduced service | $22.91 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.77 Typical High $12.30 | Professional | 53 · Discontinued | $9.33 | $9.77 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.41 Typical High $9.12 | Professional | 55 · Aftercare only | $6.92 | $7.41 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.90 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.68 | $4.90 | $6.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $24.55 Typical High $30.90 | Professional | 52 · Reduced service | $22.91 | $24.55 | $30.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.77 Typical High $12.30 | Professional | 53 · Discontinued | $9.33 | $9.77 | $12.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.41 Typical High $9.12 | Professional | 55 · Aftercare only | $6.92 | $7.41 | $9.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.90 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.68 | $4.90 | $6.17 |
Where Texas sits
The same service costs 4.4 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· 39th of 51
$61.66
HI $219FL $50.12
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.