How much rates vary
Facilitymedian $56 · 10th to 90th $40 to $95Professionalmedian $51 · 10th to 90th $42 to $692
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 $41.69 Median $41.69 Typical High $43.65 | Facility | None | $41.69 | $41.69 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $43.65 Typical High $53.70 | Professional | None | $40.74 | $43.65 | $53.70 |
Ambetter Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
BCBS Texas Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $56.23 | Professional | None | $44.67 | $44.67 | $56.23 |
Christus Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $64.57 | Facility | None | $56.23 | $56.23 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $56.23 | Professional | None | $41.69 | $41.69 | $56.23 |
Lucent Health Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $691.83 | Professional | None | $467.74 | $691.83 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $26.92 Median $52.48 Typical High $95.50 | Facility | None | $26.92 | $52.48 | $95.50 |
Moda Health Setting Professional Modifier None Typical Low $40.74 Median $43.65 Typical High $58.88 | Professional | None | $40.74 | $43.65 | $58.88 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $81.28 | Professional | None | $57.54 | $57.54 | $81.28 |
Oscar Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Providence Setting Facility Modifier None Typical Low $39.81 Median $56.23 Typical High $95.50 | Facility | None | $39.81 | $56.23 | $95.50 |
Providence Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $56.23 | Professional | None | $41.69 | $41.69 | $56.23 |
United Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $112.20 | Facility | None | $44.67 | $44.67 | $112.20 |
United Setting Professional Modifier None Typical Low $31.62 Median $45.71 Typical High $58.88 | Professional | None | $31.62 | $45.71 | $58.88 |
Wellpoint Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
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 $20.42 Median $21.88 Typical High $26.92 | Professional | 52 · Reduced service | $20.42 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.71 Typical High $10.72 | Professional | 53 · Discontinued | $8.13 | $8.71 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.46 Typical High $8.13 | Professional | 55 · Aftercare only | $6.17 | $6.46 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.07 | $4.37 | $5.37 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $21.88 Typical High $26.30 | Professional | 52 · Reduced service | $20.42 | $21.88 | $26.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.71 Typical High $10.47 | Professional | 53 · Discontinued | $8.13 | $8.71 | $10.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.46 Typical High $7.76 | Professional | 55 · Aftercare only | $6.17 | $6.46 | $7.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.37 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.07 | $4.37 | $5.25 |
Where Texas sits
The same service costs 2.6 times more in Kansas than in Arizona. 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· 33rd of 51
$51.29
KS $107AZ $41.69
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.