How much rates vary
Facilitymedian $76 · 10th to 90th $48 to $98Professionalmedian $49 · 10th to 90th $31 to $676
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 $47.86 Median $47.86 Typical High $52.48 | Facility | None | $47.86 | $47.86 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $61.66 | Professional | None | $44.67 | $48.98 | $61.66 |
BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Lucent Health Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | None | $562.34 | $562.34 | $676.08 |
Moda Health Setting Facility Modifier None Typical Low $47.86 Median $75.86 Typical High $100.00 | Facility | None | $47.86 | $75.86 | $100.00 |
Moda Health Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $64.57 | Professional | None | $44.67 | $48.98 | $64.57 |
Oscar Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Providence Setting Facility Modifier None Typical Low $48.98 Median $75.86 Typical High $100.00 | Facility | None | $48.98 | $75.86 | $100.00 |
Providence Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
United Setting Professional Modifier None Typical Low $26.30 Median $33.11 Typical High $50.12 | Professional | None | $26.30 | $33.11 | $50.12 |
Wellpoint Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
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 $22.39 Median $23.99 Typical High $30.90 | Professional | 52 · Reduced service | $22.39 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $9.77 Typical High $12.30 | Professional | 53 · Discontinued | $8.91 | $9.77 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $36.31 Typical High $46.77 | Professional | 54 · Surgery only | $33.11 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.24 Typical High $9.33 | Professional | 55 · Aftercare only | $6.61 | $7.24 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.79 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.47 | $4.79 | $6.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $23.99 Typical High $29.51 | Professional | 52 · Reduced service | $22.39 | $23.99 | $29.51 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $9.77 Typical High $11.75 | Professional | 53 · Discontinued | $8.91 | $9.77 | $11.75 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $36.31 Typical High $44.67 | Professional | 54 · Surgery only | $33.11 | $36.31 | $44.67 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.24 Typical High $8.91 | Professional | 55 · Aftercare only | $6.61 | $7.24 | $8.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.79 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.47 | $4.79 | $5.89 |
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
$48.98
HI $81.28NY $29.51
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.