How much rates vary
Facilitymedian $112 · 10th to 90th $87 to $209Professionalmedian $112 · 10th to 90th $83 to $1,514
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 $91.20 Median $91.20 Typical High $93.33 | Facility | None | $91.20 | $91.20 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $93.33 Typical High $165.96 | Professional | None | $91.20 | $93.33 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $208.93 | Professional | None | $104.71 | $147.91 | $208.93 |
BCBS Texas Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $120.23 | Professional | None | $97.72 | $97.72 | $120.23 |
Christus Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $112.20 | Professional | None | $83.18 | $83.18 | $112.20 |
Lucent Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,513.56 | $1,513.56 |
Moda Health Setting Facility Modifier None Typical Low $57.54 Median $114.82 Typical High $208.93 | Facility | None | $57.54 | $114.82 | $208.93 |
Moda Health Setting Professional Modifier None Typical Low $91.20 Median $93.33 Typical High $165.96 | Professional | None | $91.20 | $93.33 | $165.96 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $125.89 | Professional | None | $81.28 | $125.89 | $125.89 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $112.20 Typical High $208.93 | Facility | None | $87.10 | $112.20 | $208.93 |
Providence Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $112.20 | Professional | None | $83.18 | $83.18 | $112.20 |
United Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $245.47 | Facility | None | $97.72 | $97.72 | $245.47 |
United Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $128.82 | Professional | None | $69.18 | $100.00 | $128.82 |
Wellpoint Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
10 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 $44.67 Median $46.77 Typical High $58.88 | Professional | 52 · Reduced service | $44.67 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $19.05 Typical High $23.44 | Professional | 53 · Discontinued | $17.78 | $19.05 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.13 Typical High $17.38 | Professional | 55 · Aftercare only | $13.49 | $14.13 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.33 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.91 | $9.33 | $11.75 |
Cigna Setting Professional Modifier RR · Rental Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | RR · Rental | $11.22 | $11.22 | $11.22 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $46.77 Typical High $56.23 | Professional | 52 · Reduced service | $44.67 | $46.77 | $56.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $19.05 Typical High $22.39 | Professional | 53 · Discontinued | $17.78 | $19.05 | $22.39 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.13 Typical High $16.98 | Professional | 55 · Aftercare only | $13.49 | $14.13 | $16.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.33 Typical High $11.22 | Professional | 56 · Pre-op care only | $8.91 | $9.33 | $11.22 |
Providence Setting Professional Modifier RR · Rental Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | RR · Rental | $11.22 | $11.22 | $11.22 |
Where Texas sits
The same service costs 2.3 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· 28th of 51
$112
HI $200DE $85.11
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.