How much rates vary
Facilitymedian $158 · 10th to 90th $47 to $2,042Professionalmedian $30 · 10th to 90th $6 to $59
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 $16.98 Median $19.50 Typical High $33.88 | Facility | None | $16.98 | $19.50 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $30.20 Typical High $38.02 | Professional | None | $15.49 | $30.20 | $38.02 |
BCBS Texas Setting Facility Modifier None Typical Low $54.95 Median $104.71 Typical High $478.63 | Facility | None | $54.95 | $104.71 | $478.63 |
BCBS Texas Setting Professional Modifier None Typical Low $14.79 Median $28.18 Typical High $66.07 | Professional | None | $14.79 | $28.18 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $19.05 Median $33.11 Typical High $54.95 | Professional | None | $19.05 | $33.11 | $54.95 |
Lucent Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Moda Health Setting Facility Modifier None Typical Low $15.49 Median $33.88 Typical High $64.57 | Facility | None | $15.49 | $33.88 | $64.57 |
Moda Health Setting Professional Modifier None Typical Low $15.49 Median $30.20 Typical High $38.02 | Professional | None | $15.49 | $30.20 | $38.02 |
Molina Setting Professional Modifier None Typical Low $4.90 Median $27.54 Typical High $36.31 | Professional | None | $4.90 | $27.54 | $36.31 |
Oscar Health Setting Professional Modifier None Typical Low $37.15 Median $57.54 Typical High $128.82 | Professional | None | $37.15 | $57.54 | $128.82 |
Providence Setting Facility Modifier None Typical Low $16.98 Median $50.12 Typical High $151.36 | Facility | None | $16.98 | $50.12 | $151.36 |
Providence Setting Professional Modifier None Typical Low $19.05 Median $33.11 Typical High $53.70 | Professional | None | $19.05 | $33.11 | $53.70 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $16.22 Median $31.62 Typical High $56.23 | Professional | None | $16.22 | $31.62 | $56.23 |
Wellpoint Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
9 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 $7.76 Median $15.14 Typical High $18.62 | Professional | 52 · Reduced service | $7.76 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $6.03 Typical High $7.41 | Professional | 53 · Discontinued | $3.09 | $6.03 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $4.57 Typical High $5.62 | Professional | 55 · Aftercare only | $2.34 | $4.57 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $3.02 Typical High $3.72 | Professional | 56 · Pre-op care only | $1.55 | $3.02 | $3.72 |
Ambetter Setting Professional Modifier GP · Physical therapy plan Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | GP · Physical therapy plan | $31.62 | $31.62 | $31.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.76 Median $15.14 Typical High $18.20 | Professional | 52 · Reduced service | $7.76 | $15.14 | $18.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $6.03 Typical High $7.24 | Professional | 53 · Discontinued | $3.09 | $6.03 | $7.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $4.57 Typical High $5.50 | Professional | 55 · Aftercare only | $2.34 | $4.57 | $5.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $3.02 Typical High $3.63 | Professional | 56 · Pre-op care only | $1.55 | $3.02 | $3.63 |
Where Texas sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 49th of 51
$30.20
AK $91.20VA $23.99
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.