How much rates vary
Facilitymedian $151 · 10th to 90th $95 to $195Professionalmedian $98 · 10th to 90th $62 to $1,349
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 $95.50 Median $95.50 Typical High $104.71 | Facility | None | $95.50 | $95.50 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $125.89 | Professional | None | $89.13 | $97.72 | $125.89 |
BCBS Texas Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Lucent Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,348.96 | Professional | None | $1,122.02 | $1,122.02 | $1,348.96 |
Moda Health Setting Facility Modifier None Typical Low $95.50 Median $151.36 Typical High $199.53 | Facility | None | $95.50 | $151.36 | $199.53 |
Moda Health Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $128.82 | Professional | None | $89.13 | $97.72 | $128.82 |
Oscar Health Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Providence Setting Facility Modifier None Typical Low $97.72 Median $151.36 Typical High $199.53 | Facility | None | $97.72 | $151.36 | $199.53 |
Providence Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $52.48 Median $67.61 Typical High $102.33 | Professional | None | $52.48 | $67.61 | $102.33 |
Wellpoint Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
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 $44.67 Median $47.86 Typical High $61.66 | Professional | 52 · Reduced service | $44.67 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $19.50 Typical High $24.55 | Professional | 53 · Discontinued | $17.78 | $19.50 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $72.44 Typical High $93.33 | Professional | 54 · Surgery only | $66.07 | $72.44 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.45 Typical High $18.62 | Professional | 55 · Aftercare only | $13.49 | $14.45 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.77 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.91 | $9.77 | $12.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $47.86 Typical High $58.88 | Professional | 52 · Reduced service | $44.67 | $47.86 | $58.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $19.50 Typical High $23.99 | Professional | 53 · Discontinued | $17.78 | $19.50 | $23.99 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $72.44 Typical High $89.13 | Professional | 54 · Surgery only | $66.07 | $72.44 | $89.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.45 Typical High $17.78 | Professional | 55 · Aftercare only | $13.49 | $14.45 | $17.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.77 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.91 | $9.77 | $11.75 |
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· 25th of 51
$97.72
HI $162NY $58.88
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.