How much rates vary
Facilitymedian $81 · 10th to 90th $46 to $85Professionalmedian $49 · 10th to 90th $38 to $759
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 $40.74 Median $40.74 Typical High $43.65 | Facility | None | $40.74 | $40.74 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $81.28 | Professional | None | $40.74 | $40.74 | $81.28 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $70.79 Typical High $70.79 | Professional | None | $66.07 | $70.79 | $70.79 |
BCBS Texas Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $69.18 | Professional | None | $43.65 | $43.65 | $69.18 |
Christus Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $51.29 | Professional | None | $38.02 | $38.02 | $51.29 |
Lucent Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $25.70 Median $52.48 Typical High $93.33 | Facility | None | $25.70 | $52.48 | $93.33 |
Moda Health Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $81.28 | Professional | None | $40.74 | $40.74 | $81.28 |
Molina Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None | $58.88 | $58.88 | $81.28 |
Providence Setting Facility Modifier None Typical Low $39.81 Median $51.29 Typical High $93.33 | Facility | None | $39.81 | $51.29 | $93.33 |
Providence Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $51.29 | Professional | None | $38.02 | $38.02 | $51.29 |
United Setting Facility Modifier None Typical Low $53.70 Median $64.57 Typical High $93.33 | Facility | None | $53.70 | $64.57 | $93.33 |
United Setting Professional Modifier None Typical Low $33.11 Median $50.12 Typical High $60.26 | Professional | None | $33.11 | $50.12 | $60.26 |
Wellpoint Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
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 $20.42 Median $20.42 Typical High $40.74 | Professional | 52 · Reduced service | $20.42 | $20.42 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $16.22 | Professional | 53 · Discontinued | $8.13 | $8.13 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $12.02 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $8.13 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $8.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $20.42 Typical High $40.74 | Professional | 52 · Reduced service | $20.42 | $20.42 | $40.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $16.22 | Professional | 53 · Discontinued | $8.13 | $8.13 | $16.22 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $12.02 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $12.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $8.13 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $8.13 |
Where Texas sits
The same service costs 4.9 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· 35th of 51
$51.29
HI $186DE $38.02
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.