How much rates vary
Facilitymedian $33 · 10th to 90th $24 to $58Professionalmedian $31 · 10th to 90th $24 to $427
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 $25.70 Median $25.70 Typical High $26.30 | Facility | None | $25.70 | $25.70 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $26.30 Typical High $45.71 | Professional | None | $25.70 | $26.30 | $45.71 |
BCBS Texas Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $33.88 | Professional | None | $26.92 | $26.92 | $33.88 |
Christus Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $33.11 | Professional | None | $23.99 | $23.99 | $33.11 |
Lucent Health Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $426.58 | Professional | None | $288.40 | $426.58 | $426.58 |
Moda Health Setting Facility Modifier None Typical Low $16.22 Median $30.90 Typical High $57.54 | Facility | None | $16.22 | $30.90 | $57.54 |
Moda Health Setting Professional Modifier None Typical Low $25.70 Median $26.30 Typical High $45.71 | Professional | None | $25.70 | $26.30 | $45.71 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $81.28 | Professional | None | $30.90 | $30.90 | $81.28 |
Providence Setting Facility Modifier None Typical Low $24.55 Median $33.11 Typical High $57.54 | Facility | None | $24.55 | $33.11 | $57.54 |
Providence Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $33.11 | Professional | None | $23.99 | $23.99 | $33.11 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $69.18 | Facility | None | $58.88 | $58.88 | $69.18 |
United Setting Professional Modifier None Typical Low $19.50 Median $28.18 Typical High $36.31 | Professional | None | $19.50 | $28.18 | $36.31 |
Wellpoint Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
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 $12.59 Median $13.18 Typical High $16.22 | Professional | 52 · Reduced service | $12.59 | $13.18 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.25 Typical High $6.61 | Professional | 53 · Discontinued | $5.01 | $5.25 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.98 Typical High $4.90 | Professional | 55 · Aftercare only | $3.72 | $3.98 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.63 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.51 | $2.63 | $3.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.59 Median $13.18 Typical High $15.85 | Professional | 52 · Reduced service | $12.59 | $13.18 | $15.85 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.25 Typical High $6.31 | Professional | 53 · Discontinued | $5.01 | $5.25 | $6.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.98 Typical High $4.79 | Professional | 55 · Aftercare only | $3.72 | $3.98 | $4.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.63 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.51 | $2.63 | $3.16 |
Where Texas sits
The same service costs 2.6 times more in Montana than in Kansas. 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· 36th of 51
$30.90
MT $60.26KS $23.44
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.