How much rates vary
Facilitymedian $72 · 10th to 90th $14 to $72Professionalmedian $16 · 10th to 90th $12 to $240
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 $12.02 Median $12.02 Typical High $12.88 | Facility | None | $12.02 | $12.02 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $23.99 | Professional | None | $12.02 | $12.02 | $23.99 |
Ambetter Setting Professional Modifier None Typical Low $19.50 Median $20.89 Typical High $20.89 | Professional | None | $19.50 | $20.89 | $20.89 |
BCBS Texas Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $16.22 | Professional | None | $13.18 | $13.18 | $16.22 |
Christus Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $18.62 | Professional | None | $13.49 | $13.49 | $18.62 |
Lucent Health Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $239.88 | Professional | None | $162.18 | $239.88 | $239.88 |
Moda Health Setting Facility Modifier None Typical Low $8.51 Median $15.49 Typical High $28.18 | Facility | None | $8.51 | $15.49 | $28.18 |
Moda Health Setting Professional Modifier None Typical Low $12.02 Median $12.59 Typical High $23.99 | Professional | None | $12.02 | $12.59 | $23.99 |
Molina Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $81.28 | Professional | None | $15.85 | $15.85 | $81.28 |
Providence Setting Facility Modifier None Typical Low $11.75 Median $18.62 Typical High $28.18 | Facility | None | $11.75 | $18.62 | $28.18 |
Providence Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $18.62 | Professional | None | $13.49 | $13.49 | $18.62 |
United Setting Facility Modifier None Typical Low $14.45 Median $16.60 Typical High $30.90 | Facility | None | $14.45 | $16.60 | $30.90 |
United Setting Professional Modifier None Typical Low $10.96 Median $16.60 Typical High $19.95 | Professional | None | $10.96 | $16.60 | $19.95 |
Wellpoint Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
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 $6.03 Median $6.03 Typical High $12.02 | Professional | 52 · Reduced service | $6.03 | $6.03 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.40 Typical High $4.79 | Professional | 53 · Discontinued | $2.40 | $2.40 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $3.63 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.20 Typical High $2.40 | Professional | 56 · Pre-op care only | $1.20 | $1.20 | $2.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $6.03 Median $6.03 Typical High $12.02 | Professional | 52 · Reduced service | $6.03 | $6.03 | $12.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.40 Typical High $4.79 | Professional | 53 · Discontinued | $2.40 | $2.40 | $4.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $3.63 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $3.63 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.20 Typical High $2.40 | Professional | 56 · Pre-op care only | $1.20 | $1.20 | $2.40 |
Where Texas sits
The same service costs 2.8 times more in Hawaii than in Pennsylvania. 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
$16.98
HI $37.15PA $13.49
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.