How much rates vary
Facilitymedian $55 · 10th to 90th $33 to $79Professionalmedian $47 · 10th to 90th $35 to $631
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 $34.67 Median $34.67 Typical High $36.31 | Facility | None | $34.67 | $34.67 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $36.31 Typical High $45.71 | Professional | None | $33.88 | $36.31 | $45.71 |
BCBS Texas Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $58.88 | Professional | None | $37.15 | $37.15 | $58.88 |
Christus Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
Lucent Health Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $630.96 | Professional | None | $575.44 | $630.96 | $630.96 |
Moda Health Setting Facility Modifier None Typical Low $24.55 Median $43.65 Typical High $79.43 | Facility | None | $24.55 | $43.65 | $79.43 |
Moda Health Setting Professional Modifier None Typical Low $33.88 Median $36.31 Typical High $51.29 | Professional | None | $33.88 | $36.31 | $51.29 |
Molina Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None | $58.88 | $58.88 | $81.28 |
Providence Setting Facility Modifier None Typical Low $33.11 Median $54.95 Typical High $79.43 | Facility | None | $33.11 | $54.95 | $79.43 |
Providence Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
United Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $104.71 | Facility | None | $51.29 | $51.29 | $104.71 |
United Setting Professional Modifier None Typical Low $29.51 Median $41.69 Typical High $54.95 | Professional | None | $29.51 | $41.69 | $54.95 |
Wellpoint Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
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 $16.98 Median $18.20 Typical High $22.91 | Professional | 52 · Reduced service | $16.98 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $7.24 Typical High $9.12 | Professional | 53 · Discontinued | $6.76 | $7.24 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.37 Typical High $6.92 | Professional | 55 · Aftercare only | $5.13 | $5.37 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.63 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.39 | $3.63 | $4.57 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $18.20 Typical High $22.39 | Professional | 52 · Reduced service | $16.98 | $18.20 | $22.39 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $7.24 Typical High $8.91 | Professional | 53 · Discontinued | $6.76 | $7.24 | $8.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.37 Typical High $6.76 | Professional | 55 · Aftercare only | $5.13 | $5.37 | $6.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.63 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.39 | $3.63 | $4.47 |
Where Texas sits
The same service costs 3.5 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· 33rd of 51
$47.86
HI $141WV $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.