How much rates vary
Facilitymedian $89 · 10th to 90th $20 to $200Professionalmedian $19 · 10th to 90th $19 to $35
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 $18.62 Median $22.39 Typical High $44.67 | Facility | None | $18.62 | $22.39 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $19.05 | Professional | None | $18.62 | $18.62 | $19.05 |
BCBS Texas Setting Facility Modifier None Typical Low $81.28 Median $144.54 Typical High $199.53 | Facility | None | $81.28 | $144.54 | $199.53 |
BCBS Texas Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $33.11 Typical High $58.88 | Facility | None | $18.62 | $33.11 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Lucent Health Setting Professional Modifier None Typical Low $34.67 Median $53.70 Typical High $72.44 | Professional | None | $34.67 | $53.70 | $72.44 |
Moda Health Setting Facility Modifier None Typical Low $20.42 Median $20.89 Typical High $30.90 | Facility | None | $20.42 | $20.89 | $30.90 |
Moda Health Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.89 | Professional | None | $20.42 | $20.42 | $20.89 |
Molina Setting Professional Modifier None Typical Low $23.99 Median $31.62 Typical High $34.67 | Professional | None | $23.99 | $31.62 | $34.67 |
Oscar Health Setting Professional Modifier None Typical Low $21.88 Median $37.15 Typical High $74.13 | Professional | None | $21.88 | $37.15 | $74.13 |
Providence Setting Facility Modifier None Typical Low $18.62 Median $26.30 Typical High $158.49 | Facility | None | $18.62 | $26.30 | $158.49 |
Providence Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
United Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
United Setting Professional Modifier None Typical Low $20.42 Median $21.38 Typical High $22.91 | Professional | None | $20.42 | $21.38 | $22.91 |
Wellpoint Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
12 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 Facility Modifier 52 · Reduced service Typical Low $9.33 Median $11.22 Typical High $21.88 | Facility | 52 · Reduced service | $9.33 | $11.22 | $21.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.72 Median $4.47 Typical High $8.91 | Facility | 53 · Discontinued | $3.72 | $4.47 | $8.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.75 Median $3.39 Typical High $6.61 | Facility | 55 · Aftercare only | $2.75 | $3.39 | $6.61 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.24 Typical High $4.47 | Facility | 56 · Pre-op care only | $1.86 | $2.24 | $4.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.33 Median $9.33 Typical High $9.55 | Professional | 52 · Reduced service | $9.33 | $9.33 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $3.80 | Professional | 53 · Discontinued | $3.72 | $3.72 | $3.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $2.88 | Professional | 55 · Aftercare only | $2.75 | $2.75 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $1.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.23 Median $10.23 Typical High $10.47 | Professional | 52 · Reduced service | $10.23 | $10.23 | $10.47 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $4.17 | Professional | 53 · Discontinued | $4.07 | $4.07 | $4.17 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $3.16 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $3.16 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $2.09 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $2.09 |
Where Texas sits
The same service costs 1.8 times more in Hawaii than in Ohio. 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· 18th of 51
$20.42
HI $33.11OH $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.