How much rates vary
Facilitymedian $56 · 10th to 90th $28 to $68Professionalmedian $42 · 10th to 90th $30 to $562
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 $29.51 Median $29.51 Typical High $30.90 | Facility | None | $29.51 | $29.51 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $30.90 Typical High $38.90 | Professional | None | $28.84 | $30.90 | $38.90 |
BCBS Texas Setting Professional Modifier None Typical Low $31.62 Median $51.29 Typical High $51.29 | Professional | None | $31.62 | $51.29 | $51.29 |
Christus Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None | $40.74 | $40.74 | $56.23 |
Lucent Health Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $562.34 | Professional | None | $501.19 | $562.34 | $562.34 |
Moda Health Setting Facility Modifier None Typical Low $21.38 Median $37.15 Typical High $67.61 | Facility | None | $21.38 | $37.15 | $67.61 |
Moda Health Setting Professional Modifier None Typical Low $28.84 Median $30.90 Typical High $44.67 | Professional | None | $28.84 | $30.90 | $44.67 |
Molina Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $81.28 | Professional | None | $50.12 | $50.12 | $81.28 |
Providence Setting Facility Modifier None Typical Low $28.18 Median $56.23 Typical High $67.61 | Facility | None | $28.18 | $56.23 | $67.61 |
Providence Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $56.23 | Professional | None | $40.74 | $40.74 | $56.23 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $89.13 | Facility | None | $43.65 | $43.65 | $89.13 |
United Setting Professional Modifier None Typical Low $25.70 Median $35.48 Typical High $47.86 | Professional | None | $25.70 | $35.48 | $47.86 |
Wellpoint Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
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 $14.45 Median $15.49 Typical High $19.50 | Professional | 52 · Reduced service | $14.45 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $6.17 Typical High $7.76 | Professional | 53 · Discontinued | $5.75 | $6.17 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.57 Typical High $5.89 | Professional | 55 · Aftercare only | $4.37 | $4.57 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.09 Typical High $3.89 | Professional | 56 · Pre-op care only | $2.88 | $3.09 | $3.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $14.45 Median $15.49 Typical High $19.05 | Professional | 52 · Reduced service | $14.45 | $15.49 | $19.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $6.17 Typical High $7.59 | Professional | 53 · Discontinued | $5.75 | $6.17 | $7.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.57 Typical High $5.75 | Professional | 55 · Aftercare only | $4.37 | $4.57 | $5.75 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.09 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.88 | $3.09 | $3.80 |
Where Texas sits
The same service costs 3.1 times more in Hawaii than in Kentucky. 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· 29th of 51
$42.66
HI $123KY $39.81
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.