How much rates vary
Facilitymedian $126 · 10th to 90th $100 to $240Professionalmedian $117 · 10th to 90th $93 to $1,950
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 $102.33 Median $102.33 Typical High $109.65 | Facility | None | $102.33 | $102.33 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $204.17 | Professional | None | $102.33 | $102.33 | $204.17 |
BCBS Texas Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Christus Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
Lucent Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,258.93 | $1,949.84 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $61.66 Median $131.83 Typical High $239.88 | Facility | None | $61.66 | $131.83 | $239.88 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $204.17 | Professional | None | $102.33 | $102.33 | $204.17 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $128.82 Typical High $128.82 | Professional | None | $81.28 | $128.82 | $128.82 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $125.89 Typical High $239.88 | Facility | None | $100.00 | $125.89 | $239.88 |
Providence Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $125.89 | Professional | None | $93.33 | $93.33 | $125.89 |
United Setting Facility Modifier None Typical Low $100.00 Median $120.23 Typical High $223.87 | Facility | None | $100.00 | $120.23 | $223.87 |
United Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $144.54 | Professional | None | $79.43 | $120.23 | $144.54 |
Wellpoint Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
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 $51.29 Median $51.29 Typical High $102.33 | Professional | 52 · Reduced service | $51.29 | $51.29 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $40.74 | Professional | 53 · Discontinued | $20.42 | $20.42 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $30.90 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $20.42 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $20.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $51.29 Typical High $102.33 | Professional | 52 · Reduced service | $51.29 | $51.29 | $102.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $40.74 | Professional | 53 · Discontinued | $20.42 | $20.42 | $40.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $30.90 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $30.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $20.42 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $20.42 |
Where Texas sits
The same service costs 2.9 times more in Hawaii than in Florida. 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· 37th of 51
$117
HI $269FL $93.33
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.