How much rates vary
Facilitymedian $54 · 10th to 90th $47 to $102Professionalmedian $51 · 10th to 90th $39 to $661
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 $45.71 Median $45.71 Typical High $46.77 | Facility | None | $45.71 | $45.71 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $46.77 Typical High $58.88 | Professional | None | $44.67 | $46.77 | $58.88 |
BCBS Texas Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Christus Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $53.70 | Professional | None | $38.90 | $38.90 | $53.70 |
Lucent Health Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $660.69 | Professional | None | $562.34 | $660.69 | $660.69 |
Moda Health Setting Facility Modifier None Typical Low $46.77 Median $63.10 Typical High $102.33 | Facility | None | $46.77 | $63.10 | $102.33 |
Moda Health Setting Professional Modifier None Typical Low $44.67 Median $46.77 Typical High $58.88 | Professional | None | $44.67 | $46.77 | $58.88 |
Oscar Health Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Providence Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $102.33 | Facility | None | $53.70 | $53.70 | $102.33 |
Providence Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $53.70 | Professional | None | $38.90 | $38.90 | $53.70 |
United Setting Facility Modifier None Typical Low $16.98 Median $39.81 Typical High $100.00 | Facility | None | $16.98 | $39.81 | $100.00 |
United Setting Professional Modifier None Typical Low $33.88 Median $47.86 Typical High $67.61 | Professional | None | $33.88 | $47.86 | $67.61 |
Wellpoint Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $52.48 | Professional | None | $50.12 | $50.12 | $52.48 |
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 $22.39 Median $23.44 Typical High $28.84 | Professional | 52 · Reduced service | $22.39 | $23.44 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $9.33 Typical High $11.75 | Professional | 53 · Discontinued | $8.91 | $9.33 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.08 Typical High $8.71 | Professional | 55 · Aftercare only | $6.61 | $7.08 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.68 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.47 | $4.68 | $5.75 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $23.44 Typical High $28.18 | Professional | 52 · Reduced service | $22.39 | $23.44 | $28.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $9.33 Typical High $11.22 | Professional | 53 · Discontinued | $8.91 | $9.33 | $11.22 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.08 Typical High $8.51 | Professional | 55 · Aftercare only | $6.61 | $7.08 | $8.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.68 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.47 | $4.68 | $5.62 |
Where Texas sits
The same service costs 3.3 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· 29th of 51
$53.70
HI $135DE $40.74
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.