How much rates vary
Facilitymedian $23 · 10th to 90th $17 to $43Professionalmedian $20 · 10th to 90th $17 to $309
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 $18.62 Median $18.62 Typical High $19.50 | Facility | None | $18.62 | $18.62 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $19.50 Typical High $23.99 | Professional | None | $18.20 | $19.50 | $23.99 |
BCBS Texas Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Christus Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $22.91 | Professional | None | $16.98 | $16.98 | $22.91 |
Lucent Health Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $309.03 | Professional | None | $213.80 | $309.03 | $309.03 |
Moda Health Setting Facility Modifier None Typical Low $12.02 Median $22.91 Typical High $42.66 | Facility | None | $12.02 | $22.91 | $42.66 |
Moda Health Setting Professional Modifier None Typical Low $18.20 Median $19.50 Typical High $27.54 | Professional | None | $18.20 | $19.50 | $27.54 |
Molina Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $81.28 | Professional | None | $20.89 | $20.89 | $81.28 |
Providence Setting Facility Modifier None Typical Low $17.78 Median $22.91 Typical High $42.66 | Facility | None | $17.78 | $22.91 | $42.66 |
Providence Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $22.91 | Professional | None | $16.98 | $16.98 | $22.91 |
United Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $50.12 | Facility | None | $42.66 | $42.66 | $50.12 |
United Setting Professional Modifier None Typical Low $14.13 Median $20.42 Typical High $26.30 | Professional | None | $14.13 | $20.42 | $26.30 |
Wellpoint Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $22.39 | Professional | None | $13.18 | $13.18 | $22.39 |
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 $9.12 Median $9.55 Typical High $12.02 | Professional | 52 · Reduced service | $9.12 | $9.55 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.89 Typical High $4.79 | Professional | 53 · Discontinued | $3.63 | $3.89 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.88 Typical High $3.55 | Professional | 55 · Aftercare only | $2.75 | $2.88 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.95 Typical High $2.40 | Professional | 56 · Pre-op care only | $1.82 | $1.95 | $2.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $9.12 Median $9.55 Typical High $11.48 | Professional | 52 · Reduced service | $9.12 | $9.55 | $11.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.89 Typical High $4.57 | Professional | 53 · Discontinued | $3.63 | $3.89 | $4.57 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.88 Typical High $3.47 | Professional | 55 · Aftercare only | $2.75 | $2.88 | $3.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.95 Typical High $2.29 | Professional | 56 · Pre-op care only | $1.82 | $1.95 | $2.29 |
Where Texas sits
The same service costs 2.6 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· 38th of 51
$20.89
MT $43.65DE $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.