How much rates vary
Facilitymedian $71 · 10th to 90th $62 to $98Professionalmedian $55 · 10th to 90th $45 to $741
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 $42.66 Median $42.66 Typical High $44.67 | Facility | None | $42.66 | $42.66 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $44.67 Typical High $81.28 | Professional | None | $42.66 | $44.67 | $81.28 |
Ambetter Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $74.13 | Professional | None | $48.98 | $48.98 | $74.13 |
BCBS Texas Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $57.54 | Professional | None | $45.71 | $45.71 | $57.54 |
Baylor Scott & White Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $97.72 | Professional | None | $74.13 | $74.13 | $97.72 |
Christus Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $61.66 | Facility | None | $60.26 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Lucent Health Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $741.31 | Professional | None | $537.03 | $741.31 | $741.31 |
Moda Health Setting Facility Modifier None Typical Low $44.67 Median $89.13 Typical High $97.72 | Facility | None | $44.67 | $89.13 | $97.72 |
Moda Health Setting Professional Modifier None Typical Low $42.66 Median $44.67 Typical High $87.10 | Professional | None | $42.66 | $44.67 | $87.10 |
Oscar Health Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Providence Setting Facility Modifier None Typical Low $60.26 Median $61.66 Typical High $97.72 | Facility | None | $60.26 | $61.66 | $97.72 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $109.65 | Facility | None | $72.44 | $72.44 | $109.65 |
United Setting Professional Modifier None Typical Low $37.15 Median $53.70 Typical High $75.86 | Professional | None | $37.15 | $53.70 | $75.86 |
Wellpoint Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
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 $20.89 Median $22.39 Typical High $27.54 | Professional | 52 · Reduced service | $20.89 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.91 Typical High $10.96 | Professional | 53 · Discontinued | $8.32 | $8.91 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.61 Typical High $8.32 | Professional | 55 · Aftercare only | $6.31 | $6.61 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.47 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.17 | $4.47 | $5.50 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $22.39 Typical High $27.54 | Professional | 52 · Reduced service | $20.89 | $22.39 | $27.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.91 Typical High $10.96 | Professional | 53 · Discontinued | $8.32 | $8.91 | $10.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.61 Typical High $8.32 | Professional | 55 · Aftercare only | $6.31 | $6.61 | $8.32 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.47 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.17 | $4.47 | $5.50 |
Where Texas sits
The same service costs 2.1 times more in Wisconsin than in New Jersey. 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· 41st of 51
$57.54
WI $100NJ $47.86
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.