How much rates vary
Facilitymedian $51 · 10th to 90th $23 to $110Professionalmedian $26 · 10th to 90th $5 to $148
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 $24.55 Median $24.55 Typical High $25.12 | Facility | None | $24.55 | $24.55 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $24.55 Typical High $25.12 | Professional | None | $20.89 | $24.55 | $25.12 |
Ambetter Setting Professional Modifier None Typical Low $15.14 Median $19.50 Typical High $19.50 | Professional | None | $15.14 | $19.50 | $19.50 |
BCBS Texas Setting Facility Modifier None Typical Low $32.36 Median $74.13 Typical High $120.23 | Facility | None | $32.36 | $74.13 | $120.23 |
BCBS Texas Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $87.10 | Professional | None | $22.39 | $22.39 | $87.10 |
Christus Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Lucent Health Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $223.87 | Professional | None | $147.91 | $223.87 | $223.87 |
Moda Health Setting Facility Modifier None Typical Low $19.95 Median $24.55 Typical High $70.79 | Facility | None | $19.95 | $24.55 | $70.79 |
Moda Health Setting Professional Modifier None Typical Low $22.39 Median $24.55 Typical High $32.36 | Professional | None | $22.39 | $24.55 | $32.36 |
Molina Setting Professional Modifier None Typical Low $4.90 Median $28.18 Typical High $36.31 | Professional | None | $4.90 | $28.18 | $36.31 |
Providence Setting Facility Modifier None Typical Low $19.95 Median $25.12 Typical High $36.31 | Facility | None | $19.95 | $25.12 | $36.31 |
Providence Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
United Setting Professional Modifier None Typical Low $16.98 Median $23.99 Typical High $35.48 | Professional | None | $16.98 | $23.99 | $35.48 |
Wellpoint Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
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 $10.47 Median $12.30 Typical High $12.59 | Professional | 52 · Reduced service | $10.47 | $12.30 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.90 Typical High $5.01 | Professional | 53 · Discontinued | $4.17 | $4.90 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.63 Typical High $3.80 | Professional | 55 · Aftercare only | $3.16 | $3.63 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.45 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.09 | $2.45 | $2.51 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.96 Median $12.30 Typical High $12.59 | Professional | 52 · Reduced service | $10.96 | $12.30 | $12.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.90 Typical High $5.01 | Professional | 53 · Discontinued | $4.37 | $4.90 | $5.01 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.63 Typical High $3.80 | Professional | 55 · Aftercare only | $3.31 | $3.63 | $3.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.45 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.19 | $2.45 | $2.51 |
Where Texas sits
The same service costs 4.1 times more in Wyoming 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· 27th of 51
$26.30
WY $75.86KY $18.62
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.