How much rates vary
Facilitymedian $100 · 10th to 90th $89 to $219Professionalmedian $100 · 10th to 90th $72 to $1,230
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 $93.33 Median $93.33 Typical High $100.00 | Facility | None | $93.33 | $93.33 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $186.21 | Professional | None | $93.33 | $93.33 | $186.21 |
BCBS Texas Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Christus Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Lucent Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,202.26 | $1,230.27 | $1,230.27 |
Moda Health Setting Facility Modifier None Typical Low $51.29 Median $120.23 Typical High $218.78 | Facility | None | $51.29 | $120.23 | $218.78 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $186.21 | Professional | None | $93.33 | $93.33 | $186.21 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $123.03 | Professional | None | $81.28 | $123.03 | $123.03 |
Providence Setting Facility Modifier None Typical Low $91.20 Median $100.00 Typical High $218.78 | Facility | None | $91.20 | $100.00 | $218.78 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
United Setting Facility Modifier None Typical Low $102.33 Median $107.15 Typical High $186.21 | Facility | None | $102.33 | $107.15 | $186.21 |
United Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $120.23 | Professional | None | $66.07 | $100.00 | $120.23 |
Wellpoint Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
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 $46.77 Median $46.77 Typical High $93.33 | Professional | 52 · Reduced service | $46.77 | $46.77 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $37.15 | Professional | 53 · Discontinued | $18.62 | $18.62 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $28.18 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $18.62 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $18.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $46.77 Typical High $93.33 | Professional | 52 · Reduced service | $46.77 | $46.77 | $93.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $37.15 | Professional | 53 · Discontinued | $18.62 | $18.62 | $37.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $28.18 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $28.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $18.62 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $18.62 |
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· 31st of 51
$100
HI $295DE $72.44
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.