How much rates vary
Facilitymedian $16 · 10th to 90th $12 to $29Professionalmedian $16 · 10th to 90th $11 to $214
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 $12.88 Median $12.88 Typical High $13.18 | Facility | None | $12.88 | $12.88 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $12.59 Median $13.18 Typical High $16.22 | Professional | None | $12.59 | $13.18 | $16.22 |
BCBS Texas Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $16.98 | Professional | None | $13.49 | $13.49 | $16.98 |
Christus Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $15.85 | Professional | None | $11.48 | $11.48 | $15.85 |
Lucent Health Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $213.80 | Professional | None | $144.54 | $213.80 | $213.80 |
Moda Health Setting Facility Modifier None Typical Low $8.13 Median $16.22 Typical High $28.84 | Facility | None | $8.13 | $16.22 | $28.84 |
Moda Health Setting Professional Modifier None Typical Low $12.59 Median $13.18 Typical High $18.20 | Professional | None | $12.59 | $13.18 | $18.20 |
Molina Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $81.28 | Professional | None | $17.38 | $17.38 | $81.28 |
Providence Setting Facility Modifier None Typical Low $12.30 Median $15.85 Typical High $28.84 | Facility | None | $12.30 | $15.85 | $28.84 |
Providence Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $15.85 | Professional | None | $11.48 | $11.48 | $15.85 |
United Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $34.67 | Facility | None | $13.49 | $13.49 | $34.67 |
United Setting Professional Modifier None Typical Low $9.77 Median $14.13 Typical High $18.20 | Professional | None | $9.77 | $14.13 | $18.20 |
Wellpoint Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | None | $15.49 | $15.49 | $15.49 |
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 $6.31 Median $6.61 Typical High $8.13 | Professional | 52 · Reduced service | $6.31 | $6.61 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.63 Typical High $3.24 | Professional | 53 · Discontinued | $2.51 | $2.63 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $2.00 Typical High $2.45 | Professional | 55 · Aftercare only | $1.86 | $2.00 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $1.32 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.26 | $1.32 | $1.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $6.31 Median $6.61 Typical High $7.94 | Professional | 52 · Reduced service | $6.31 | $6.61 | $7.94 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.63 Typical High $3.16 | Professional | 53 · Discontinued | $2.51 | $2.63 | $3.16 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $2.00 Typical High $2.40 | Professional | 55 · Aftercare only | $1.86 | $2.00 | $2.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $1.32 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.26 | $1.32 | $1.58 |
Where Texas sits
The same service costs 5.5 times more in Kansas 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· 28th of 51
$15.85
KS $63.10DE $11.48
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.