How much rates vary
Facilitymedian $380 · 10th to 90th $79 to $741Professionalmedian $79 · 10th to 90th $68 to $138
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 $67.61 Median $120.23 Typical High $173.78 | Facility | None | $67.61 | $120.23 | $173.78 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $33.88 Median $63.10 Typical High $87.10 | Facility | 52 · Reduced service | $33.88 | $63.10 | $87.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $13.49 Median $25.12 Typical High $34.67 | Facility | 53 · Discontinued | $13.49 | $25.12 | $34.67 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.00 Median $19.05 Typical High $26.30 | Facility | 55 · Aftercare only | $10.00 | $19.05 | $26.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.76 Median $12.59 Typical High $17.38 | Facility | 56 · Pre-op care only | $6.76 | $12.59 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $100.00 | Professional | None | $67.61 | $67.61 | $100.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $33.88 Typical High $37.15 | Professional | 52 · Reduced service | $33.88 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $14.79 | Professional | 53 · Discontinued | $13.49 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.23 Typical High $10.96 | Professional | 55 · Aftercare only | $10.00 | $10.23 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $7.41 |
BCBS Texas Setting Facility Modifier None Typical Low $338.84 Median $489.78 Typical High $758.58 | Facility | None | $338.84 | $489.78 | $758.58 |
BCBS Texas Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $158.49 Typical High $213.80 | Facility | None | $67.61 | $158.49 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Moda Health Setting Facility Modifier None Typical Low $79.43 Median $114.82 Typical High $346.74 | Facility | None | $79.43 | $114.82 | $346.74 |
Moda Health Setting Professional Modifier None Typical Low $67.61 Median $79.43 Typical High $100.00 | Professional | None | $67.61 | $79.43 | $100.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $39.81 Typical High $40.74 | Professional | 52 · Reduced service | $39.81 | $39.81 | $40.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $15.85 | $16.22 | $16.22 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $12.30 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $12.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $8.13 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Providence Setting Facility Modifier None Typical Low $67.61 Median $95.50 Typical High $575.44 | Facility | None | $67.61 | $95.50 | $575.44 |
Providence Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
United Setting Professional Modifier None Typical Low $79.43 Median $85.11 Typical High $89.13 | Professional | None | $79.43 | $85.11 | $89.13 |
Wellpoint Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
1 more rate 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 |
|---|---|---|---|---|---|
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $177.83 Median $354.81 Typical High $691.83 | Facility | JZ · No drug discarded | $177.83 | $354.81 | $691.83 |
Where Texas sits
The same service costs 2.7 times more in South Carolina than in Georgia. 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· 8th of 51
$115
SC $182GA $67.61
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.