How much rates vary
Facilitymedian $71 · 10th to 90th $36 to $132Professionalmedian $65 · 10th to 90th $51 to $955
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 $57.54 Median $57.54 Typical High $58.88 | Facility | None | $57.54 | $57.54 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $58.88 Typical High $74.13 | Professional | None | $56.23 | $58.88 | $74.13 |
BCBS Texas Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $75.86 | Professional | None | $60.26 | $60.26 | $75.86 |
Christus Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
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 $645.65 Median $954.99 Typical High $954.99 | Professional | None | $645.65 | $954.99 | $954.99 |
Moda Health Setting Facility Modifier None Typical Low $36.31 Median $69.18 Typical High $131.83 | Facility | None | $36.31 | $69.18 | $131.83 |
Moda Health Setting Professional Modifier None Typical Low $56.23 Median $58.88 Typical High $83.18 | Professional | None | $56.23 | $58.88 | $83.18 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $81.28 | Professional | None | $64.57 | $64.57 | $81.28 |
Providence Setting Facility Modifier None Typical Low $53.70 Median $70.79 Typical High $131.83 | Facility | None | $53.70 | $70.79 | $131.83 |
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 $131.83 Median $131.83 Typical High $154.88 | Facility | None | $131.83 | $131.83 | $154.88 |
United Setting Professional Modifier None Typical Low $43.65 Median $63.10 Typical High $81.28 | Professional | None | $43.65 | $63.10 | $81.28 |
Wellpoint Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $67.61 | Professional | None | $66.07 | $66.07 | $67.61 |
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 $28.18 Median $29.51 Typical High $36.31 | Professional | 52 · Reduced service | $28.18 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.75 Typical High $14.79 | Professional | 53 · Discontinued | $11.22 | $11.75 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.91 Typical High $10.96 | Professional | 55 · Aftercare only | $8.32 | $8.91 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.89 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.62 | $5.89 | $7.41 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $29.51 Typical High $35.48 | Professional | 52 · Reduced service | $28.18 | $29.51 | $35.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.75 Typical High $14.13 | Professional | 53 · Discontinued | $11.22 | $11.75 | $14.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.91 Typical High $10.72 | Professional | 55 · Aftercare only | $8.32 | $8.91 | $10.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.89 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.62 | $5.89 | $7.08 |
Where Texas sits
The same service costs 2.6 times more in Hawaii 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· 32nd of 51
$66.07
HI $132DE $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.