How much rates vary
Facilitymedian $30 · 10th to 90th $23 to $78Professionalmedian $28 · 10th to 90th $19 to $339
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 $19.50 Median $19.50 Typical High $21.38 | Facility | None | $19.50 | $19.50 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $39.81 | Professional | None | $19.50 | $19.50 | $39.81 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $45.71 | Professional | None | $34.67 | $34.67 | $45.71 |
BCBS Texas Setting Professional Modifier None Typical Low $21.38 Median $26.92 Typical High $26.92 | Professional | None | $21.38 | $26.92 | $26.92 |
Baylor Scott & White Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $45.71 | Professional | None | $34.67 | $34.67 | $45.71 |
Christus Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $34.67 Typical High $34.67 | Facility | None | $30.20 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Lucent Health Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $338.84 | Professional | None | $323.59 | $338.84 | $338.84 |
Moda Health Setting Facility Modifier None Typical Low $19.50 Median $45.71 Typical High $295.12 | Facility | None | $19.50 | $45.71 | $295.12 |
Moda Health Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $39.81 | Professional | None | $19.50 | $19.50 | $39.81 |
Molina Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $81.28 | Professional | None | $23.99 | $23.99 | $81.28 |
Oscar Health Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
Providence Setting Facility Modifier None Typical Low $19.50 Median $34.67 Typical High $45.71 | Facility | None | $19.50 | $34.67 | $45.71 |
Providence Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
United Setting Facility Modifier None Typical Low $16.22 Median $29.51 Typical High $50.12 | Facility | None | $16.22 | $29.51 | $50.12 |
United Setting Professional Modifier None Typical Low $18.20 Median $27.54 Typical High $33.11 | Professional | None | $18.20 | $27.54 | $33.11 |
Wellpoint Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
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 $9.77 Median $9.77 Typical High $19.50 | Professional | 52 · Reduced service | $9.77 | $9.77 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $3.98 Typical High $7.94 | Professional | 53 · Discontinued | $3.98 | $3.98 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $2.95 Typical High $5.89 | Professional | 55 · Aftercare only | $2.95 | $2.95 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $3.98 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $3.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $9.77 Median $9.77 Typical High $19.50 | Professional | 52 · Reduced service | $9.77 | $9.77 | $19.50 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $3.98 Typical High $7.94 | Professional | 53 · Discontinued | $3.98 | $3.98 | $7.94 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $2.95 Typical High $5.89 | Professional | 55 · Aftercare only | $2.95 | $2.95 | $5.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $3.98 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $3.98 |
Where Texas sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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· 35th of 51
$30.20
HI $77.62DC $24.55
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.