How much rates vary
Facilitymedian $27 · 10th to 90th $13 to $47Professionalmedian $23 · 10th to 90th $20 to $347
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 $20.42 Median $20.42 Typical High $21.38 | Facility | None | $20.42 | $20.42 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $21.38 Typical High $29.51 | Professional | None | $20.42 | $21.38 | $29.51 |
BCBS Texas Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $27.54 | Professional | None | $21.88 | $21.88 | $27.54 |
Christus Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $26.92 | Professional | None | $19.95 | $19.95 | $26.92 |
Lucent Health Setting Professional Modifier None Typical Low $234.42 Median $346.74 Typical High $346.74 | Professional | None | $234.42 | $346.74 | $346.74 |
Moda Health Setting Facility Modifier None Typical Low $13.18 Median $24.55 Typical High $46.77 | Facility | None | $13.18 | $24.55 | $46.77 |
Moda Health Setting Professional Modifier None Typical Low $20.42 Median $21.38 Typical High $30.20 | Professional | None | $20.42 | $21.38 | $30.20 |
Molina Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $81.28 | Professional | None | $22.91 | $22.91 | $81.28 |
Providence Setting Facility Modifier None Typical Low $19.50 Median $26.92 Typical High $46.77 | Facility | None | $19.50 | $26.92 | $46.77 |
Providence Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $26.92 | Professional | None | $19.95 | $19.95 | $26.92 |
United Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $56.23 | Facility | None | $47.86 | $47.86 | $56.23 |
United Setting Professional Modifier None Typical Low $15.85 Median $22.91 Typical High $29.51 | Professional | None | $15.85 | $22.91 | $29.51 |
Wellpoint Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $24.55 | Professional | None | $23.99 | $23.99 | $24.55 |
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 $10.00 Median $10.72 Typical High $13.18 | Professional | 52 · Reduced service | $10.00 | $10.72 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.27 Typical High $5.25 | Professional | 53 · Discontinued | $4.07 | $4.27 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.24 Typical High $3.98 | Professional | 55 · Aftercare only | $3.02 | $3.24 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.14 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.04 | $2.14 | $2.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.23 Median $10.72 Typical High $12.88 | Professional | 52 · Reduced service | $10.23 | $10.72 | $12.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.27 Typical High $5.13 | Professional | 53 · Discontinued | $4.07 | $4.27 | $5.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.24 Typical High $3.89 | Professional | 55 · Aftercare only | $3.02 | $3.24 | $3.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.14 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.04 | $2.14 | $2.57 |
Where Texas sits
The same service costs 2.5 times more in Montana than in Delaware. 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· 40th of 51
$23.99
MT $48.98DE $19.95
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.