How much rates vary
Facilitymedian $65 · 10th to 90th $50 to $117Professionalmedian $65 · 10th to 90th $47 to $871
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 $52.48 Median $52.48 Typical High $53.70 | Facility | None | $52.48 | $52.48 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $53.70 Typical High $67.61 | Professional | None | $51.29 | $53.70 | $67.61 |
BCBS Texas Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $69.18 | Professional | None | $54.95 | $54.95 | $69.18 |
Christus Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
Lucent Health Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $870.96 | Professional | None | $588.84 | $870.96 | $870.96 |
Moda Health Setting Facility Modifier None Typical Low $33.11 Median $66.07 Typical High $117.49 | Facility | None | $33.11 | $66.07 | $117.49 |
Moda Health Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $75.86 | Professional | None | $52.48 | $53.70 | $75.86 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $81.28 | Professional | None | $77.62 | $77.62 | $81.28 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $64.57 Typical High $117.49 | Facility | None | $50.12 | $64.57 | $117.49 |
Providence Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $64.57 | Professional | None | $46.77 | $46.77 | $64.57 |
United Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $141.25 | Facility | None | $120.23 | $120.23 | $141.25 |
United Setting Professional Modifier None Typical Low $39.81 Median $57.54 Typical High $74.13 | Professional | None | $39.81 | $57.54 | $74.13 |
Wellpoint Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
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 $25.70 Median $26.92 Typical High $33.11 | Professional | 52 · Reduced service | $25.70 | $26.92 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.72 Typical High $13.49 | Professional | 53 · Discontinued | $10.23 | $10.72 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $8.13 Typical High $10.00 | Professional | 55 · Aftercare only | $7.59 | $8.13 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.37 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.13 | $5.37 | $6.61 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $26.92 Typical High $32.36 | Professional | 52 · Reduced service | $25.70 | $26.92 | $32.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.72 Typical High $12.88 | Professional | 53 · Discontinued | $10.23 | $10.72 | $12.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $8.13 Typical High $9.77 | Professional | 55 · Aftercare only | $7.59 | $8.13 | $9.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.37 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.13 | $5.37 | $6.46 |
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· 27th of 51
$64.57
HI $120DE $46.77
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.