How much rates vary
Facilitymedian $25 · 10th to 90th $15 to $36Professionalmedian $19 · 10th to 90th $16 to $263
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 $15.85 Median $15.85 Typical High $16.60 | Facility | None | $15.85 | $15.85 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $16.60 Typical High $20.42 | Professional | None | $15.49 | $16.60 | $20.42 |
BCBS Texas Setting Professional Modifier None Typical Low $16.98 Median $20.89 Typical High $20.89 | Professional | None | $16.98 | $20.89 | $20.89 |
Christus Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | None | $17.78 | $17.78 | $24.55 |
Lucent Health Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $263.03 | Professional | None | $181.97 | $263.03 | $263.03 |
Moda Health Setting Facility Modifier None Typical Low $10.23 Median $19.05 Typical High $36.31 | Facility | None | $10.23 | $19.05 | $36.31 |
Moda Health Setting Professional Modifier None Typical Low $15.49 Median $16.60 Typical High $23.44 | Professional | None | $15.49 | $16.60 | $23.44 |
Molina Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $81.28 | Professional | None | $17.78 | $17.78 | $81.28 |
Providence Setting Facility Modifier None Typical Low $15.14 Median $24.55 Typical High $36.31 | Facility | None | $15.14 | $24.55 | $36.31 |
Providence Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $24.55 | Professional | None | $17.78 | $17.78 | $24.55 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $42.66 | Facility | None | $36.31 | $36.31 | $42.66 |
United Setting Professional Modifier None Typical Low $12.02 Median $17.38 Typical High $22.39 | Professional | None | $12.02 | $17.38 | $22.39 |
Wellpoint Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $19.05 | Professional | None | $18.62 | $18.62 | $19.05 |
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 $7.76 Median $8.32 Typical High $10.23 | Professional | 52 · Reduced service | $7.76 | $8.32 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.31 Typical High $4.07 | Professional | 53 · Discontinued | $3.09 | $3.31 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $2.45 Typical High $3.02 | Professional | 55 · Aftercare only | $2.34 | $2.45 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.66 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.55 | $1.66 | $2.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.76 Median $8.32 Typical High $9.77 | Professional | 52 · Reduced service | $7.76 | $8.32 | $9.77 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.31 Typical High $3.98 | Professional | 53 · Discontinued | $3.09 | $3.31 | $3.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $2.45 Typical High $2.95 | Professional | 55 · Aftercare only | $2.34 | $2.45 | $2.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.66 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.55 | $1.66 | $1.95 |
Where Texas sits
The same service costs 2.1 times more in Montana 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
$19.95
MT $37.15WV $17.78
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.