How much rates vary
Facilitymedian $20 · 10th to 90th $13 to $24Professionalmedian $13 · 10th to 90th $8 to $162
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 $12.88 Median $12.88 Typical High $13.80 | Facility | None | $12.88 | $12.88 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $12.88 Typical High $16.98 | Professional | None | $12.02 | $12.88 | $16.98 |
BCBS Texas Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Lucent Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $162.18 | Professional | None | $151.36 | $151.36 | $162.18 |
Moda Health Setting Facility Modifier None Typical Low $12.88 Median $19.95 Typical High $25.12 | Facility | None | $12.88 | $19.95 | $25.12 |
Moda Health Setting Professional Modifier None Typical Low $12.02 Median $12.88 Typical High $16.98 | Professional | None | $12.02 | $12.88 | $16.98 |
Oscar Health Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Providence Setting Facility Modifier None Typical Low $12.88 Median $19.95 Typical High $23.99 | Facility | None | $12.88 | $19.95 | $23.99 |
Providence Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
United Setting Professional Modifier None Typical Low $6.92 Median $8.91 Typical High $13.49 | Professional | None | $6.92 | $8.91 | $13.49 |
Wellpoint Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
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 $5.89 Median $6.46 Typical High $8.32 | Professional | 52 · Reduced service | $5.89 | $6.46 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.57 Typical High $3.31 | Professional | 53 · Discontinued | $2.40 | $2.57 | $3.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.91 Median $9.77 Typical High $12.30 | Professional | 54 · Surgery only | $8.91 | $9.77 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $1.95 Typical High $2.45 | Professional | 55 · Aftercare only | $1.78 | $1.95 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.29 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.20 | $1.29 | $1.66 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.89 Median $6.46 Typical High $7.94 | Professional | 52 · Reduced service | $5.89 | $6.46 | $7.94 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.57 Typical High $3.16 | Professional | 53 · Discontinued | $2.40 | $2.57 | $3.16 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $8.91 Median $9.77 Typical High $12.02 | Professional | 54 · Surgery only | $8.91 | $9.77 | $12.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $1.95 Typical High $2.40 | Professional | 55 · Aftercare only | $1.78 | $1.95 | $2.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.29 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.20 | $1.29 | $1.58 |
Where Texas sits
The same service costs 2.8 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
$12.88
HI $21.88NY $7.94
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.