How much rates vary
Facilitymedian $34 · 10th to 90th $21 to $50Professionalmedian $27 · 10th to 90th $22 to $363
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 $21.88 Median $21.88 Typical High $22.91 | Facility | None | $21.88 | $21.88 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $22.91 Typical High $28.18 | Professional | None | $21.38 | $22.91 | $28.18 |
BCBS Texas Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $38.90 | Professional | None | $23.44 | $23.44 | $38.90 |
Christus Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None | $24.55 | $24.55 | $33.88 |
Lucent Health Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $363.08 | Professional | None | $251.19 | $363.08 | $363.08 |
Moda Health Setting Facility Modifier None Typical Low $14.13 Median $27.54 Typical High $50.12 | Facility | None | $14.13 | $27.54 | $50.12 |
Moda Health Setting Professional Modifier None Typical Low $21.38 Median $22.91 Typical High $32.36 | Professional | None | $21.38 | $22.91 | $32.36 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $81.28 | Professional | None | $26.92 | $26.92 | $81.28 |
Providence Setting Facility Modifier None Typical Low $21.38 Median $33.88 Typical High $50.12 | Facility | None | $21.38 | $33.88 | $50.12 |
Providence Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.88 | Professional | None | $24.55 | $24.55 | $33.88 |
United Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $60.26 | Facility | None | $50.12 | $50.12 | $60.26 |
United Setting Professional Modifier None Typical Low $16.98 Median $23.99 Typical High $31.62 | Professional | None | $16.98 | $23.99 | $31.62 |
Wellpoint Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
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 $10.72 Median $11.48 Typical High $14.13 | Professional | 52 · Reduced service | $10.72 | $11.48 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.57 Typical High $5.62 | Professional | 53 · Discontinued | $4.37 | $4.57 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.47 Typical High $4.27 | Professional | 55 · Aftercare only | $3.24 | $3.47 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.29 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.14 | $2.29 | $2.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.72 Median $11.48 Typical High $13.80 | Professional | 52 · Reduced service | $10.72 | $11.48 | $13.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.57 Typical High $5.50 | Professional | 53 · Discontinued | $4.37 | $4.57 | $5.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.47 Typical High $4.07 | Professional | 55 · Aftercare only | $3.24 | $3.47 | $4.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.29 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.14 | $2.29 | $2.75 |
Where Texas sits
The same service costs 3.1 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· 31st of 51
$26.92
MT $52.48KS $16.98
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.