How much rates vary
Facilitymedian $302 · 10th to 90th $151 to $355Professionalmedian $257 · 10th to 90th $151 to $2,818
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 $151.36 Median $151.36 Typical High $165.96 | Facility | None | $151.36 | $151.36 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $309.03 | Professional | None | $151.36 | $151.36 | $309.03 |
BCBS Texas Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Christus Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | None | $257.04 | $257.04 | $302.00 |
Lucent Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,041.74 | $2,818.38 | $2,818.38 |
Moda Health Setting Facility Modifier None Typical Low $109.65 Median $194.98 Typical High $354.81 | Facility | None | $109.65 | $194.98 | $354.81 |
Moda Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $309.03 | Professional | None | $151.36 | $151.36 | $309.03 |
Providence Setting Facility Modifier None Typical Low $151.36 Median $302.00 Typical High $354.81 | Facility | None | $151.36 | $302.00 | $354.81 |
Providence Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | None | $257.04 | $257.04 | $302.00 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $257.04 | Professional | None | $141.25 | $213.80 | $257.04 |
Wellpoint Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
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 $75.86 Median $75.86 Typical High $151.36 | Professional | 52 · Reduced service | $75.86 | $75.86 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $61.66 | Professional | 53 · Discontinued | $30.90 | $30.90 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $45.71 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $30.90 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $30.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $75.86 Typical High $151.36 | Professional | 52 · Reduced service | $75.86 | $75.86 | $151.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $61.66 | Professional | 53 · Discontinued | $30.90 | $30.90 | $61.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $45.71 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $45.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $30.90 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $30.90 |
Where Texas sits
The same service costs 3.0 times more in Iowa than in New York. 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· 33rd of 51
$257
IA $457NY $151
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.