How much rates vary
Facilitymedian $35 · 10th to 90th $28 to $76Professionalmedian $38 · 10th to 90th $25 to $490
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 $32.36 Median $32.36 Typical High $34.67 | Facility | None | $32.36 | $32.36 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $64.57 | Professional | None | $32.36 | $32.36 | $64.57 |
Ambetter Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
BCBS Texas Setting Professional Modifier None Typical Low $35.48 Median $43.65 Typical High $43.65 | Professional | None | $35.48 | $43.65 | $43.65 |
Christus Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $34.67 | Professional | None | $25.12 | $25.12 | $34.67 |
Lucent Health Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $489.78 | Professional | None | $371.54 | $489.78 | $489.78 |
Moda Health Setting Facility Modifier None Typical Low $17.78 Median $41.69 Typical High $75.86 | Facility | None | $17.78 | $41.69 | $75.86 |
Moda Health Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $64.57 | Professional | None | $32.36 | $32.36 | $64.57 |
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 $31.62 Median $34.67 Typical High $75.86 | Facility | None | $31.62 | $34.67 | $75.86 |
Providence Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $34.67 | Professional | None | $25.12 | $25.12 | $34.67 |
United Setting Facility Modifier None Typical Low $27.54 Median $29.51 Typical High $64.57 | Facility | None | $27.54 | $29.51 | $64.57 |
United Setting Professional Modifier None Typical Low $22.91 Median $34.67 Typical High $41.69 | Professional | None | $22.91 | $34.67 | $41.69 |
Wellpoint Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
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 $16.22 Median $16.22 Typical High $32.36 | Professional | 52 · Reduced service | $16.22 | $16.22 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $12.88 | Professional | 53 · Discontinued | $6.46 | $6.46 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $9.77 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $6.46 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $6.46 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $16.22 Typical High $32.36 | Professional | 52 · Reduced service | $16.22 | $16.22 | $32.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $12.88 | Professional | 53 · Discontinued | $6.46 | $6.46 | $12.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $9.77 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $9.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $6.46 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $6.46 |
Where Texas sits
The same service costs 2.5 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· 26th of 51
$36.31
HI $64.57DE $25.70
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.