How much rates vary
Facilitymedian $43 · 10th to 90th $27 to $49Professionalmedian $28 · 10th to 90th $17 to $324
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 $26.92 Median $26.92 Typical High $29.51 | Facility | None | $26.92 | $26.92 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $27.54 Typical High $35.48 | Professional | None | $25.12 | $27.54 | $35.48 |
BCBS Texas Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Lucent Health Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $323.59 | Professional | None | $281.84 | $323.59 | $323.59 |
Moda Health Setting Facility Modifier None Typical Low $26.92 Median $42.66 Typical High $48.98 | Facility | None | $26.92 | $42.66 | $48.98 |
Moda Health Setting Professional Modifier None Typical Low $25.12 Median $27.54 Typical High $36.31 | Professional | None | $25.12 | $27.54 | $36.31 |
Oscar Health Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Providence Setting Facility Modifier None Typical Low $27.54 Median $42.66 Typical High $50.12 | Facility | None | $27.54 | $42.66 | $50.12 |
Providence Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
United Setting Professional Modifier None Typical Low $14.79 Median $19.05 Typical High $28.84 | Professional | None | $14.79 | $19.05 | $28.84 |
Wellpoint Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
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 $12.59 Median $13.80 Typical High $17.78 | Professional | 52 · Reduced service | $12.59 | $13.80 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.50 Typical High $7.08 | Professional | 53 · Discontinued | $5.01 | $5.50 | $7.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.05 Median $20.42 Typical High $26.30 | Professional | 54 · Surgery only | $19.05 | $20.42 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $4.17 Typical High $5.25 | Professional | 55 · Aftercare only | $3.80 | $4.17 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.75 Typical High $3.55 | Professional | 56 · Pre-op care only | $2.51 | $2.75 | $3.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.59 Median $13.80 Typical High $16.98 | Professional | 52 · Reduced service | $12.59 | $13.80 | $16.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.50 Typical High $6.76 | Professional | 53 · Discontinued | $5.01 | $5.50 | $6.76 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $19.05 Median $20.42 Typical High $25.12 | Professional | 54 · Surgery only | $19.05 | $20.42 | $25.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $4.17 Typical High $5.01 | Professional | 55 · Aftercare only | $3.80 | $4.17 | $5.01 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.75 Typical High $3.39 | Professional | 56 · Pre-op care only | $2.51 | $2.75 | $3.39 |
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
$27.54
HI $45.71NY $16.60
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.