How much rates vary
Facilitymedian $14 · 10th to 90th $8 to $19Professionalmedian $13 · 10th to 90th $9 to $191
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 $8.32 Median $8.32 Typical High $8.91 | Facility | None | $8.32 | $8.32 | $8.91 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $16.60 | Professional | None | $8.32 | $8.32 | $16.60 |
Ambetter Setting Professional Modifier None Typical Low $13.49 Median $14.45 Typical High $14.45 | Professional | None | $13.49 | $14.45 | $14.45 |
BCBS Texas Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $17.78 | Professional | None | $8.91 | $8.91 | $17.78 |
Christus Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | None | $10.47 | $10.47 | $14.45 |
Lucent Health Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $190.55 | Professional | None | $128.82 | $190.55 | $190.55 |
Moda Health Setting Facility Modifier None Typical Low $6.03 Median $10.72 Typical High $19.05 | Facility | None | $6.03 | $10.72 | $19.05 |
Moda Health Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $16.60 | Professional | None | $8.32 | $8.32 | $16.60 |
Molina Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $81.28 | Professional | None | $10.47 | $10.47 | $81.28 |
Providence Setting Facility Modifier None Typical Low $8.13 Median $14.45 Typical High $19.05 | Facility | None | $8.13 | $14.45 | $19.05 |
Providence Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | None | $10.47 | $10.47 | $14.45 |
United Setting Facility Modifier None Typical Low $12.59 Median $12.88 Typical High $21.88 | Facility | None | $12.59 | $12.88 | $21.88 |
United Setting Professional Modifier None Typical Low $7.94 Median $11.75 Typical High $14.13 | Professional | None | $7.94 | $11.75 | $14.13 |
Wellpoint Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
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 $4.17 Median $4.17 Typical High $8.32 | Professional | 52 · Reduced service | $4.17 | $4.17 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.66 Median $1.66 Typical High $3.31 | Professional | 53 · Discontinued | $1.66 | $1.66 | $3.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $2.45 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.83 Median $0.83 Typical High $1.66 | Professional | 56 · Pre-op care only | $0.83 | $0.83 | $1.66 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $4.17 Median $4.17 Typical High $8.32 | Professional | 52 · Reduced service | $4.17 | $4.17 | $8.32 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.66 Median $1.66 Typical High $3.31 | Professional | 53 · Discontinued | $1.66 | $1.66 | $3.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $2.45 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $2.45 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.83 Median $0.83 Typical High $1.66 | Professional | 56 · Pre-op care only | $0.83 | $0.83 | $1.66 |
Where Texas sits
The same service costs 3.0 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· 39th of 51
$12.59
HI $31.62DE $10.47
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.