How much rates vary
Facilitymedian $17 · 10th to 90th $11 to $20Professionalmedian $11 · 10th to 90th $7 to $132
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 $10.96 Median $10.96 Typical High $12.02 | Facility | None | $10.96 | $10.96 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $10.23 Median $10.96 Typical High $14.45 | Professional | None | $10.23 | $10.96 | $14.45 |
BCBS Texas Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Lucent Health Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $131.83 | Professional | None | $128.82 | $128.82 | $131.83 |
Moda Health Setting Facility Modifier None Typical Low $10.96 Median $16.98 Typical High $21.38 | Facility | None | $10.96 | $16.98 | $21.38 |
Moda Health Setting Professional Modifier None Typical Low $10.23 Median $10.96 Typical High $14.45 | Professional | None | $10.23 | $10.96 | $14.45 |
Oscar Health Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Providence Setting Facility Modifier None Typical Low $10.96 Median $16.98 Typical High $20.42 | Facility | None | $10.96 | $16.98 | $20.42 |
Providence Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
United Setting Professional Modifier None Typical Low $5.89 Median $7.59 Typical High $11.48 | Professional | None | $5.89 | $7.59 | $11.48 |
Wellpoint Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
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 $5.13 Median $5.50 Typical High $7.08 | Professional | 52 · Reduced service | $5.13 | $5.50 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $2.19 Typical High $2.82 | Professional | 53 · Discontinued | $2.04 | $2.19 | $2.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.59 Median $8.32 Typical High $10.72 | Professional | 54 · Surgery only | $7.59 | $8.32 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.66 Typical High $2.14 | Professional | 55 · Aftercare only | $1.51 | $1.66 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.02 Median $1.12 Typical High $1.41 | Professional | 56 · Pre-op care only | $1.02 | $1.12 | $1.41 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.13 Median $5.50 Typical High $6.76 | Professional | 52 · Reduced service | $5.13 | $5.50 | $6.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $2.19 Typical High $2.69 | Professional | 53 · Discontinued | $2.04 | $2.19 | $2.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $7.59 Median $8.32 Typical High $10.23 | Professional | 54 · Surgery only | $7.59 | $8.32 | $10.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.66 Typical High $2.04 | Professional | 55 · Aftercare only | $1.51 | $1.66 | $2.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.02 Median $1.12 Typical High $1.35 | Professional | 56 · Pre-op care only | $1.02 | $1.12 | $1.35 |
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
$10.96
HI $18.62NY $6.76
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.