How much rates vary
Facilitymedian $69 · 10th to 90th $38 to $89Professionalmedian $59 · 10th to 90th $39 to $661
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 $38.90 Median $38.90 Typical High $41.69 | Facility | None | $38.90 | $38.90 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $77.62 | Professional | None | $38.90 | $38.90 | $77.62 |
BCBS Texas Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Christus Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | None | $58.88 | $58.88 | $69.18 |
Lucent Health Setting Professional Modifier None Typical Low $446.68 Median $660.69 Typical High $660.69 | Professional | None | $446.68 | $660.69 | $660.69 |
Moda Health Setting Facility Modifier None Typical Low $25.12 Median $50.12 Typical High $89.13 | Facility | None | $25.12 | $50.12 | $89.13 |
Moda Health Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $77.62 | Professional | None | $38.90 | $38.90 | $77.62 |
Providence Setting Facility Modifier None Typical Low $38.02 Median $69.18 Typical High $89.13 | Facility | None | $38.02 | $69.18 | $89.13 |
Providence Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | None | $58.88 | $58.88 | $69.18 |
United Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $107.15 | Facility | None | $91.20 | $91.20 | $107.15 |
United Setting Professional Modifier None Typical Low $32.36 Median $48.98 Typical High $58.88 | Professional | None | $32.36 | $48.98 | $58.88 |
Wellpoint Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
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 $19.50 Median $19.50 Typical High $38.90 | Professional | 52 · Reduced service | $19.50 | $19.50 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $15.49 | Professional | 53 · Discontinued | $7.76 | $7.76 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $11.48 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $7.76 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $7.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $19.50 Typical High $38.90 | Professional | 52 · Reduced service | $19.50 | $19.50 | $38.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $15.49 | Professional | 53 · Discontinued | $7.76 | $7.76 | $15.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $11.48 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $11.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $7.76 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $7.76 |
Where Texas sits
The same service costs 2.0 times more in Montana than in South Carolina. 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· 27th of 51
$58.88
MT $93.33SC $46.77
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.