How much rates vary
Facilitymedian $170 · 10th to 90th $126 to $398Professionalmedian $126 · 10th to 90th $100 to $1,096
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 $97.72 Median $97.72 Typical High $100.00 | Facility | None | $97.72 | $97.72 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $100.00 | Professional | None | $97.72 | $97.72 | $100.00 |
BCBS Texas Setting Facility Modifier None Typical Low $134.90 Median $181.97 Typical High $426.58 | Facility | None | $134.90 | $181.97 | $426.58 |
BCBS Texas Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Christus Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $169.82 Typical High $316.23 | Facility | None | $125.89 | $169.82 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Lucent Health Setting Professional Modifier None Typical Low $660.69 Median $1,096.48 Typical High $1,096.48 | Professional | None | $660.69 | $1,096.48 | $1,096.48 |
Moda Health Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $141.25 | Facility | None | $97.72 | $97.72 | $141.25 |
Moda Health Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $107.15 | Professional | None | $97.72 | $97.72 | $107.15 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $107.15 Typical High $107.15 | Professional | None | $30.20 | $107.15 | $107.15 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $169.82 Typical High $302.00 | Facility | None | $125.89 | $169.82 | $302.00 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Wellpoint Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
8 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 $48.98 Median $48.98 Typical High $50.12 | Professional | 52 · Reduced service | $48.98 | $48.98 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $19.95 | Professional | 53 · Discontinued | $19.50 | $19.50 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $15.14 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $10.00 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $10.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $48.98 Typical High $50.12 | Professional | 52 · Reduced service | $48.98 | $48.98 | $50.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $19.95 | Professional | 53 · Discontinued | $19.50 | $19.50 | $19.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $15.14 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $15.14 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $10.00 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $10.00 |
Where Texas sits
The same service costs 2.0 times more in Alaska than in North Carolina. 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· 19th of 51
$126
AK $182NC $89.13
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.