How much rates vary
Facilitymedian $34 · 10th to 90th $14 to $51Professionalmedian $28 · 10th to 90th $22 to $380
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 $22.91 Median $22.91 Typical High $23.44 | Facility | None | $22.91 | $22.91 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $23.44 Typical High $28.84 | Professional | None | $22.39 | $23.44 | $28.84 |
BCBS Texas Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Christus Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
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 $257.04 Median $380.19 Typical High $380.19 | Professional | None | $257.04 | $380.19 | $380.19 |
Moda Health Setting Facility Modifier None Typical Low $14.45 Median $27.54 Typical High $51.29 | Facility | None | $14.45 | $27.54 | $51.29 |
Moda Health Setting Professional Modifier None Typical Low $22.39 Median $23.44 Typical High $33.11 | Professional | None | $22.39 | $23.44 | $33.11 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $81.28 | Professional | None | $38.02 | $38.02 | $81.28 |
Providence Setting Facility Modifier None Typical Low $21.38 Median $33.88 Typical High $51.29 | Facility | None | $21.38 | $33.88 | $51.29 |
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 $52.48 Median $52.48 Typical High $61.66 | Facility | None | $52.48 | $52.48 | $61.66 |
United Setting Professional Modifier None Typical Low $17.38 Median $25.12 Typical High $32.36 | Professional | None | $17.38 | $25.12 | $32.36 |
Wellpoint Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
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 $11.22 Median $11.75 Typical High $14.45 | Professional | 52 · Reduced service | $11.22 | $11.75 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.68 Typical High $5.89 | Professional | 53 · Discontinued | $4.47 | $4.68 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.55 Typical High $4.37 | Professional | 55 · Aftercare only | $3.31 | $3.55 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.34 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.24 | $2.34 | $2.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $11.22 Median $11.75 Typical High $14.13 | Professional | 52 · Reduced service | $11.22 | $11.75 | $14.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.68 Typical High $5.62 | Professional | 53 · Discontinued | $4.47 | $4.68 | $5.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.55 Typical High $4.27 | Professional | 55 · Aftercare only | $3.31 | $3.55 | $4.27 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.34 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.24 | $2.34 | $2.82 |
Where Texas sits
The same service costs 2.2 times more in Montana than in Arizona. 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· 27th of 51
$28.84
MT $53.70AZ $24.55
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.