How much rates vary
Facilitymedian $129 · 10th to 90th $76 to $200Professionalmedian $110 · 10th to 90th $87 to $1,445
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 $87.10 Median $87.10 Typical High $91.20 | Facility | None | $87.10 | $87.10 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $91.20 Typical High $151.36 | Professional | None | $85.11 | $91.20 | $151.36 |
BCBS Texas Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $151.36 | Professional | None | $93.33 | $151.36 | $151.36 |
Christus Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $128.82 | Professional | None | $95.50 | $95.50 | $128.82 |
Lucent Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,000.00 | $1,445.44 | $1,445.44 |
Moda Health Setting Facility Modifier None Typical Low $56.23 Median $104.71 Typical High $199.53 | Facility | None | $56.23 | $104.71 | $199.53 |
Moda Health Setting Professional Modifier None Typical Low $85.11 Median $91.20 Typical High $158.49 | Professional | None | $85.11 | $91.20 | $158.49 |
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 $83.18 Median $128.82 Typical High $199.53 | Facility | None | $83.18 | $128.82 | $199.53 |
Providence Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $128.82 | Professional | None | $95.50 | $95.50 | $128.82 |
United Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $234.42 | Facility | None | $199.53 | $199.53 | $234.42 |
United Setting Professional Modifier None Typical Low $66.07 Median $95.50 Typical High $123.03 | Professional | None | $66.07 | $95.50 | $123.03 |
Wellpoint Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
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 $42.66 Median $45.71 Typical High $56.23 | Professional | 52 · Reduced service | $42.66 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.20 Typical High $22.39 | Professional | 53 · Discontinued | $16.98 | $18.20 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.49 Typical High $16.98 | Professional | 55 · Aftercare only | $12.88 | $13.49 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.12 Typical High $11.22 | Professional | 56 · Pre-op care only | $8.51 | $9.12 | $11.22 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $45.71 Typical High $54.95 | Professional | 52 · Reduced service | $42.66 | $45.71 | $54.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.20 Typical High $21.88 | Professional | 53 · Discontinued | $16.98 | $18.20 | $21.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.49 Typical High $16.22 | Professional | 55 · Aftercare only | $12.88 | $13.49 | $16.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.12 Typical High $10.96 | Professional | 56 · Pre-op care only | $8.51 | $9.12 | $10.96 |
Where Texas sits
The same service costs 2.5 times more in Kansas than in Utah. 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· 34th of 51
$112
KS $234UT $95.50
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.