How much rates vary
Facilitymedian $78 · 10th to 90th $47 to $78Professionalmedian $50 · 10th to 90th $47 to $851
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 $46.77 Median $46.77 Typical High $47.86 | Facility | None | $46.77 | $46.77 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $47.86 Typical High $83.18 | Professional | None | $46.77 | $47.86 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $79.43 | Professional | None | $52.48 | $52.48 | $79.43 |
BCBS Texas Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $61.66 | Professional | None | $48.98 | $48.98 | $61.66 |
Baylor Scott & White Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $104.71 | Professional | None | $79.43 | $79.43 | $104.71 |
Christus Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $72.44 | Facility | None | $67.61 | $67.61 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Lucent Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $27.54 Median $54.95 Typical High $104.71 | Facility | None | $27.54 | $54.95 | $104.71 |
Moda Health Setting Professional Modifier None Typical Low $46.77 Median $47.86 Typical High $83.18 | Professional | None | $46.77 | $47.86 | $83.18 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $81.28 | Professional | None | $53.70 | $53.70 | $81.28 |
Oscar Health Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Providence Setting Facility Modifier None Typical Low $44.67 Median $67.61 Typical High $104.71 | Facility | None | $44.67 | $67.61 | $104.71 |
Providence Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
United Setting Facility Modifier None Typical Low $67.61 Median $77.62 Typical High $117.49 | Facility | None | $67.61 | $77.62 | $117.49 |
United Setting Professional Modifier None Typical Low $38.90 Median $54.95 Typical High $72.44 | Professional | None | $38.90 | $54.95 | $72.44 |
Wellpoint Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
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 $22.91 Median $23.99 Typical High $30.20 | Professional | 52 · Reduced service | $22.91 | $23.99 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.55 Typical High $12.02 | Professional | 53 · Discontinued | $9.12 | $9.55 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.24 Typical High $8.91 | Professional | 55 · Aftercare only | $6.76 | $7.24 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.79 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.57 | $4.79 | $6.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $23.99 Typical High $29.51 | Professional | 52 · Reduced service | $22.91 | $23.99 | $29.51 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.55 Typical High $11.75 | Professional | 53 · Discontinued | $9.12 | $9.55 | $11.75 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.24 Typical High $8.91 | Professional | 55 · Aftercare only | $6.76 | $7.24 | $8.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.79 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.57 | $4.79 | $5.89 |
Where Texas sits
The same service costs 4.1 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· 49th of 51
$53.70
HI $209DE $51.29
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.