How much rates vary
Facilitymedian $49 · 10th to 90th $25 to $79Professionalmedian $49 · 10th to 90th $34 to $603
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 $33.88 Median $33.88 Typical High $37.15 | Facility | None | $33.88 | $33.88 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $67.61 | Professional | None | $33.88 | $33.88 | $67.61 |
BCBS Texas Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Christus Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
Lucent Health Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $602.56 | Professional | None | $524.81 | $602.56 | $602.56 |
Moda Health Setting Facility Modifier None Typical Low $25.12 Median $43.65 Typical High $79.43 | Facility | None | $25.12 | $43.65 | $79.43 |
Moda Health Setting Professional Modifier None Typical Low $33.88 Median $35.48 Typical High $67.61 | Professional | None | $33.88 | $35.48 | $67.61 |
Molina Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $81.28 | Professional | None | $41.69 | $41.69 | $81.28 |
Providence Setting Facility Modifier None Typical Low $33.11 Median $48.98 Typical High $79.43 | Facility | None | $33.11 | $48.98 | $79.43 |
Providence Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
United Setting Facility Modifier None Typical Low $19.95 Median $39.81 Typical High $89.13 | Facility | None | $19.95 | $39.81 | $89.13 |
United Setting Professional Modifier None Typical Low $32.36 Median $48.98 Typical High $58.88 | Professional | None | $32.36 | $48.98 | $58.88 |
Wellpoint Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
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 $16.98 Median $16.98 Typical High $33.88 | Professional | 52 · Reduced service | $16.98 | $16.98 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $13.80 | Professional | 53 · Discontinued | $6.76 | $6.76 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $10.23 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $6.76 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $6.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $16.98 Typical High $33.88 | Professional | 52 · Reduced service | $16.98 | $16.98 | $33.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $13.80 | Professional | 53 · Discontinued | $6.76 | $6.76 | $13.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $10.23 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $10.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $6.76 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $6.76 |
Where Texas sits
The same service costs 2.8 times more in Montana than in New Jersey. 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
$48.98
MT $107NJ $38.90
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.