How much rates vary
Facilitymedian $45 · 10th to 90th $28 to $59Professionalmedian $29 · 10th to 90th $18 to $407
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 $28.18 Median $28.18 Typical High $30.90 | Facility | None | $28.18 | $28.18 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $28.84 Typical High $37.15 | Professional | None | $26.30 | $28.84 | $37.15 |
BCBS Texas Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Lucent Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $407.38 | Professional | None | $338.84 | $338.84 | $407.38 |
Moda Health Setting Facility Modifier None Typical Low $28.18 Median $44.67 Typical High $60.26 | Facility | None | $28.18 | $44.67 | $60.26 |
Moda Health Setting Professional Modifier None Typical Low $26.92 Median $28.84 Typical High $38.02 | Professional | None | $26.92 | $28.84 | $38.02 |
Oscar Health Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Providence Setting Facility Modifier None Typical Low $28.84 Median $44.67 Typical High $60.26 | Facility | None | $28.84 | $44.67 | $60.26 |
Providence Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
United Setting Professional Modifier None Typical Low $15.49 Median $19.95 Typical High $30.20 | Professional | None | $15.49 | $19.95 | $30.20 |
Wellpoint Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
10 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 $13.18 Median $14.45 Typical High $18.62 | Professional | 52 · Reduced service | $13.18 | $14.45 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.75 Typical High $7.41 | Professional | 53 · Discontinued | $5.25 | $5.75 | $7.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $21.38 Typical High $28.18 | Professional | 54 · Surgery only | $19.95 | $21.38 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.37 Typical High $5.62 | Professional | 55 · Aftercare only | $3.98 | $4.37 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.88 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.63 | $2.88 | $3.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $14.45 Typical High $17.78 | Professional | 52 · Reduced service | $13.18 | $14.45 | $17.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.75 Typical High $7.08 | Professional | 53 · Discontinued | $5.25 | $5.75 | $7.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $21.38 Typical High $26.92 | Professional | 54 · Surgery only | $19.95 | $21.38 | $26.92 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.37 Typical High $5.37 | Professional | 55 · Aftercare only | $3.98 | $4.37 | $5.37 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.88 Typical High $3.55 | Professional | 56 · Pre-op care only | $2.63 | $2.88 | $3.55 |
Where Texas sits
The same service costs 2.7 times more in Hawaii 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· 26th of 51
$28.84
HI $47.86NY $17.78
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.