How much rates vary
Facilitymedian $60 · 10th to 90th $60 to $209Professionalmedian $105 · 10th to 90th $93 to $1,585
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 $93.33 Median $93.33 Typical High $97.72 | Facility | None | $93.33 | $93.33 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $97.72 Typical High $169.82 | Professional | None | $93.33 | $97.72 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $162.18 Typical High $162.18 | Professional | None | $107.15 | $162.18 | $162.18 |
BCBS Texas Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $125.89 | Professional | None | $100.00 | $100.00 | $125.89 |
Christus Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
Lucent Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,584.89 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $60.26 Median $117.49 Typical High $213.80 | Facility | None | $60.26 | $117.49 | $213.80 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $97.72 Typical High $169.82 | Professional | None | $93.33 | $97.72 | $169.82 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $104.71 Typical High $104.71 | Professional | None | $81.28 | $104.71 | $104.71 |
Providence Setting Facility Modifier None Typical Low $91.20 Median $141.25 Typical High $213.80 | Facility | None | $91.20 | $141.25 | $213.80 |
Providence Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
United Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $257.04 | Facility | None | $218.78 | $218.78 | $257.04 |
United Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $134.90 | Professional | None | $72.44 | $104.71 | $134.90 |
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 $45.71 Median $48.98 Typical High $60.26 | Professional | 52 · Reduced service | $45.71 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.50 Typical High $23.99 | Professional | 53 · Discontinued | $18.62 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.79 Typical High $18.20 | Professional | 55 · Aftercare only | $13.80 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.77 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.33 | $9.77 | $12.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $48.98 Typical High $58.88 | Professional | 52 · Reduced service | $45.71 | $48.98 | $58.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.50 Typical High $23.44 | Professional | 53 · Discontinued | $18.62 | $19.50 | $23.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.79 Typical High $17.78 | Professional | 55 · Aftercare only | $13.80 | $14.79 | $17.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.77 Typical High $11.75 | Professional | 56 · Pre-op care only | $9.33 | $9.77 | $11.75 |
Where Texas sits
The same service costs 2.0 times more in Wyoming than in New Jersey. 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· 43rd of 51
$105
WY $209NJ $102
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.