How much rates vary
Facilitymedian $37 · 10th to 90th $23 to $46Professionalmedian $23 · 10th to 90th $15 to $316
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 $23.44 Median $23.44 Typical High $25.70 | Facility | None | $23.44 | $23.44 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $23.44 Typical High $30.90 | Professional | None | $21.88 | $23.44 | $30.90 |
BCBS Texas Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Lucent Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $316.23 | Professional | None | $275.42 | $275.42 | $316.23 |
Moda Health Setting Facility Modifier None Typical Low $23.44 Median $37.15 Typical High $45.71 | Facility | None | $23.44 | $37.15 | $45.71 |
Moda Health Setting Professional Modifier None Typical Low $21.88 Median $23.44 Typical High $31.62 | Professional | None | $21.88 | $23.44 | $31.62 |
Oscar Health Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Providence Setting Facility Modifier None Typical Low $23.44 Median $37.15 Typical High $45.71 | Facility | None | $23.44 | $37.15 | $45.71 |
Providence Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
United Setting Professional Modifier None Typical Low $12.88 Median $16.22 Typical High $24.55 | Professional | None | $12.88 | $16.22 | $24.55 |
Wellpoint Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
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 $10.96 Median $11.75 Typical High $15.14 | Professional | 52 · Reduced service | $10.96 | $11.75 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.79 Typical High $6.03 | Professional | 53 · Discontinued | $4.37 | $4.79 | $6.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.22 Median $17.78 Typical High $22.91 | Professional | 54 · Surgery only | $16.22 | $17.78 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.55 Typical High $4.57 | Professional | 55 · Aftercare only | $3.24 | $3.55 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.34 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.19 | $2.34 | $3.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.96 Median $11.75 Typical High $14.45 | Professional | 52 · Reduced service | $10.96 | $11.75 | $14.45 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.79 Typical High $5.75 | Professional | 53 · Discontinued | $4.37 | $4.79 | $5.75 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $16.22 Median $17.78 Typical High $21.88 | Professional | 54 · Surgery only | $16.22 | $17.78 | $21.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.55 Typical High $4.37 | Professional | 55 · Aftercare only | $3.24 | $3.55 | $4.37 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.34 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.19 | $2.34 | $2.88 |
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
$23.44
HI $39.81NY $14.45
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.