How much rates vary
Facilitymedian $54 · 10th to 90th $35 to $126Professionalmedian $31 · 10th to 90th $20 to $363
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 $30.90 Median $30.90 Typical High $33.88 | Facility | None | $30.90 | $30.90 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $30.90 Typical High $40.74 | Professional | None | $28.84 | $30.90 | $40.74 |
BCBS Texas Setting Facility Modifier None Typical Low $38.02 Median $61.66 Typical High $134.90 | Facility | None | $38.02 | $61.66 | $134.90 |
BCBS Texas Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Lucent Health Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $363.08 | Professional | None | $331.13 | $363.08 | $363.08 |
Moda Health Setting Facility Modifier None Typical Low $30.90 Median $48.98 Typical High $54.95 | Facility | None | $30.90 | $48.98 | $54.95 |
Moda Health Setting Professional Modifier None Typical Low $28.84 Median $30.90 Typical High $40.74 | Professional | None | $28.84 | $30.90 | $40.74 |
Oscar Health Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Providence Setting Facility Modifier None Typical Low $30.90 Median $48.98 Typical High $57.54 | Facility | None | $30.90 | $48.98 | $57.54 |
Providence Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
United Setting Professional Modifier None Typical Low $16.98 Median $21.38 Typical High $32.36 | Professional | None | $16.98 | $21.38 | $32.36 |
Wellpoint Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
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 $14.45 Median $15.49 Typical High $19.95 | Professional | 52 · Reduced service | $14.45 | $15.49 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $6.31 Typical High $7.94 | Professional | 53 · Discontinued | $5.75 | $6.31 | $7.94 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $23.44 Typical High $30.20 | Professional | 54 · Surgery only | $21.38 | $23.44 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.68 Typical High $6.03 | Professional | 55 · Aftercare only | $4.27 | $4.68 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.09 Typical High $3.98 | Professional | 56 · Pre-op care only | $2.88 | $3.09 | $3.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $14.45 Median $15.49 Typical High $19.05 | Professional | 52 · Reduced service | $14.45 | $15.49 | $19.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $6.31 Typical High $7.59 | Professional | 53 · Discontinued | $5.75 | $6.31 | $7.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $23.44 Typical High $28.84 | Professional | 54 · Surgery only | $21.38 | $23.44 | $28.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.68 Typical High $5.75 | Professional | 55 · Aftercare only | $4.27 | $4.68 | $5.75 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.09 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.88 | $3.09 | $3.80 |
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
$30.90
HI $51.29NY $18.62
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.