How much rates vary
Facilitymedian $91 · 10th to 90th $63 to $251Professionalmedian $52 · 10th to 90th $44 to $54
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 $52.48 Median $53.70 Typical High $128.82 | Facility | None | $52.48 | $53.70 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $54.95 | Professional | None | $52.48 | $53.70 | $54.95 |
BCBS Texas Setting Facility Modifier None Typical Low $64.57 Median $162.18 Typical High $281.84 | Facility | None | $64.57 | $162.18 | $281.84 |
BCBS Texas Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Christus Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $70.79 Typical High $151.36 | Facility | None | $47.86 | $70.79 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Moda Health Setting Facility Modifier None Typical Low $53.70 Median $93.33 Typical High $263.03 | Facility | None | $53.70 | $93.33 | $263.03 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $87.10 Median $128.82 Typical High $223.87 | Facility | JZ · No drug discarded | $87.10 | $128.82 | $223.87 |
Moda Health Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $54.95 | Professional | None | $52.48 | $53.70 | $54.95 |
Molina Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Providence Setting Facility Modifier None Typical Low $47.86 Median $70.79 Typical High $407.38 | Facility | None | $47.86 | $70.79 | $407.38 |
Providence Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
United Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
United Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Wellpoint Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
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 $26.30 Median $26.92 Typical High $27.54 | Professional | 52 · Reduced service | $26.30 | $26.92 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.96 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $8.13 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.50 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $26.92 Typical High $27.54 | Professional | 52 · Reduced service | $26.30 | $26.92 | $27.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.96 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $7.94 | $8.13 | $8.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.50 |
Where Texas sits
The same service costs 1.7 times more in Arizona than in Rhode Island. 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· 5th of 51
$74.13
AZ $83.18RI $47.86
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.