How much rates vary
Facilitymedian $49 · 10th to 90th $21 to $68Professionalmedian $38 · 10th to 90th $30 to $676
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 $28.84 Median $29.51 Typical High $41.69 | Facility | None | $28.84 | $29.51 | $41.69 |
Aetna Setting Professional Modifier None (both parts) Typical Low $29.51 Median $30.90 Typical High $53.70 | Professional | None (both parts) | $29.51 | $30.90 | $53.70 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $28.84 Median $43.65 Typical High $67.61 | Professional | None (both parts) | $28.84 | $43.65 | $67.61 |
BCBS Texas Setting Professional Modifier None (both parts) Typical Low $31.62 Median $31.62 Typical High $38.90 | Professional | None (both parts) | $31.62 | $31.62 | $38.90 |
Baylor Scott & White Setting Professional Modifier None (both parts) Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None (both parts) | $50.12 | $50.12 | $67.61 |
Christus Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Cigna Setting Professional Modifier None (both parts) Typical Low $33.11 Median $33.11 Typical High $45.71 | Professional | None (both parts) | $33.11 | $33.11 | $45.71 |
Health Smart Setting Professional Modifier None (both parts) Typical Low $37.15 Median $66.07 Typical High $81.28 | Professional | None (both parts) | $37.15 | $66.07 | $81.28 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $524.81 Median $524.81 Typical High $676.08 | Professional | None (both parts) | $524.81 | $524.81 | $676.08 |
Moda Health Setting Facility Modifier None Typical Low $16.22 Median $29.51 Typical High $67.61 | Facility | None | $16.22 | $29.51 | $67.61 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $29.51 Median $30.90 Typical High $64.57 | Professional | None (both parts) | $29.51 | $30.90 | $64.57 |
Molina Setting Professional Modifier None (both parts) Typical Low $38.02 Median $38.02 Typical High $81.28 | Professional | None (both parts) | $38.02 | $38.02 | $81.28 |
Oscar Health Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None (both parts) | $251.19 | $251.19 | $251.19 |
Providence Setting Facility Modifier None Typical Low $28.18 Median $45.71 Typical High $67.61 | Facility | None | $28.18 | $45.71 | $67.61 |
Providence Setting Professional Modifier None (both parts) Typical Low $33.11 Median $33.11 Typical High $45.71 | Professional | None (both parts) | $33.11 | $33.11 | $45.71 |
United Setting Facility Modifier None Typical Low $43.65 Median $52.48 Typical High $75.86 | Facility | None | $43.65 | $52.48 | $75.86 |
United Setting Professional Modifier None (both parts) Typical Low $25.12 Median $35.48 Typical High $46.77 | Professional | None (both parts) | $25.12 | $35.48 | $46.77 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None (both parts) | $39.81 | $39.81 | $39.81 |
11 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 $14.45 Median $15.49 Typical High $19.50 | Professional | 52 · Reduced service | $14.45 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $6.17 Typical High $7.76 | Professional | 53 · Discontinued | $5.75 | $6.17 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.57 Typical High $5.75 | Professional | 55 · Aftercare only | $4.37 | $4.57 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.09 Typical High $3.89 | Professional | 56 · Pre-op care only | $2.88 | $3.09 | $3.89 |
Christus Setting Professional Modifier 26 · Professional part Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 26 · Professional part | $40.74 | $40.74 | $40.74 |
Cigna Setting Professional Modifier RR · Rental Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | RR · Rental | $4.57 | $4.57 | $4.57 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $14.45 Median $15.49 Typical High $19.05 | Professional | 52 · Reduced service | $14.45 | $15.49 | $19.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $6.17 Typical High $7.59 | Professional | 53 · Discontinued | $5.75 | $6.17 | $7.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.57 Typical High $5.75 | Professional | 55 · Aftercare only | $4.37 | $4.57 | $5.75 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.09 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.88 | $3.09 | $3.80 |
Providence Setting Professional Modifier RR · Rental Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | RR · Rental | $4.57 | $4.57 | $4.57 |
Where Texas sits
The same service costs 3.8 times more in Hawaii than in Florida. 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· 45th of 51
$38.90
HI $126FL $33.11
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.