How much rates vary
Facilitymedian $100 · 10th to 90th $55 to $129Professionalmedian $85 · 10th to 90th $56 to $955
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 $56.23 Median $56.23 Typical High $60.26 | Facility | None | $56.23 | $56.23 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $112.20 | Professional | None | $56.23 | $56.23 | $112.20 |
BCBS Texas Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $75.86 | Professional | None | $60.26 | $75.86 | $75.86 |
Christus Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $100.00 | Professional | None | $85.11 | $85.11 | $100.00 |
Lucent Health Setting Professional Modifier None Typical Low $645.65 Median $954.99 Typical High $954.99 | Professional | None | $645.65 | $954.99 | $954.99 |
Moda Health Setting Facility Modifier None Typical Low $36.31 Median $72.44 Typical High $128.82 | Facility | None | $36.31 | $72.44 | $128.82 |
Moda Health Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $112.20 | Professional | None | $56.23 | $56.23 | $112.20 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $85.11 Typical High $85.11 | Professional | None | $81.28 | $85.11 | $85.11 |
Providence Setting Facility Modifier None Typical Low $54.95 Median $100.00 Typical High $128.82 | Facility | None | $54.95 | $100.00 | $128.82 |
Providence Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $100.00 | Professional | None | $85.11 | $85.11 | $100.00 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $154.88 | Facility | None | $131.83 | $131.83 | $154.88 |
United Setting Professional Modifier None Typical Low $46.77 Median $70.79 Typical High $85.11 | Professional | None | $46.77 | $70.79 | $85.11 |
Wellpoint Setting Professional Modifier None Typical Low $128.82 Median $331.13 Typical High $331.13 | Professional | None | $128.82 | $331.13 | $331.13 |
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 $28.18 Median $28.18 Typical High $56.23 | Professional | 52 · Reduced service | $28.18 | $28.18 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $22.39 | Professional | 53 · Discontinued | $11.22 | $11.22 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $16.60 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $11.22 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $11.22 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $28.18 Typical High $56.23 | Professional | 52 · Reduced service | $28.18 | $28.18 | $56.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $22.39 | Professional | 53 · Discontinued | $11.22 | $11.22 | $22.39 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $16.60 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $16.60 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $11.22 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $11.22 |
Where Texas sits
The same service costs 2.4 times more in Indiana than in Kentucky. 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· 43rd of 51
$85.11
IN $162KY $67.61
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.