How much rates vary
Facilitymedian $71 · 10th to 90th $38 to $100Professionalmedian $55 · 10th to 90th $44 to $724
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 $57.54 | Professional | None | $43.65 | $45.71 | $57.54 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
BCBS Texas Setting Professional Modifier None Typical Low $46.77 Median $58.88 Typical High $58.88 | Professional | None | $46.77 | $58.88 | $58.88 |
Christus Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Lucent Health Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $724.44 | Professional | None | $501.19 | $724.44 | $724.44 |
Moda Health Setting Facility Modifier None Typical Low $28.18 Median $52.48 Typical High $100.00 | Facility | None | $28.18 | $52.48 | $100.00 |
Moda Health Setting Professional Modifier None Typical Low $43.65 Median $45.71 Typical High $64.57 | Professional | None | $43.65 | $45.71 | $64.57 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $81.28 | Professional | None | $66.07 | $66.07 | $81.28 |
Providence Setting Facility Modifier None Typical Low $42.66 Median $70.79 Typical High $100.00 | Facility | None | $42.66 | $70.79 | $100.00 |
Providence Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $120.23 | Facility | None | $102.33 | $102.33 | $120.23 |
United Setting Professional Modifier None Typical Low $33.88 Median $48.98 Typical High $63.10 | Professional | None | $33.88 | $48.98 | $63.10 |
Wellpoint Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
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 $8.71 Median $9.12 Typical High $11.22 | Professional | 53 · Discontinued | $8.71 | $9.12 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.92 Typical High $8.51 | Professional | 55 · Aftercare only | $6.46 | $6.92 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.57 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.37 | $4.57 | $5.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $22.91 Typical High $27.54 | Professional | 52 · Reduced service | $21.38 | $22.91 | $27.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.12 Typical High $10.96 | Professional | 53 · Discontinued | $8.71 | $9.12 | $10.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.92 Typical High $8.13 | Professional | 55 · Aftercare only | $6.46 | $6.92 | $8.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.57 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.37 | $4.57 | $5.50 |
Where Texas sits
The same service costs 2.0 times more in Hawaii than in West Virginia. 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· 25th of 51
$56.23
HI $102WV $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.