How much rates vary
Facilitymedian $32 · 10th to 90th $16 to $69Professionalmedian $10 · 10th to 90th $8 to $17
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 $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $20.89 | Professional | None | $10.00 | $10.00 | $20.89 |
Ambetter Setting Professional Modifier None Typical Low $10.00 Median $14.45 Typical High $16.98 | Professional | None | $10.00 | $14.45 | $16.98 |
BCBS Texas Setting Facility Modifier None Typical Low $16.60 Median $38.90 Typical High $69.18 | Facility | None | $16.60 | $38.90 | $69.18 |
BCBS Texas Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
Baylor Scott & White Setting Facility Modifier None Typical Low $12.30 Median $37.15 Typical High $42.66 | Facility | None | $12.30 | $37.15 | $42.66 |
Christus Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Facility | None | $16.98 | $16.98 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Facility | None | $9.55 | $9.55 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $13.80 Typical High $14.79 | Professional | None | $10.00 | $13.80 | $14.79 |
Health Smart Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $19.95 | Professional | None | $14.45 | $14.45 | $19.95 |
Lucent Health Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $19.95 | Professional | None | $14.45 | $14.45 | $19.95 |
Moda Health Setting Facility Modifier None Typical Low $12.88 Median $40.74 Typical High $123.03 | Facility | None | $12.88 | $40.74 | $123.03 |
Moda Health Setting Professional Modifier None Typical Low $9.12 Median $10.00 Typical High $25.12 | Professional | None | $9.12 | $10.00 | $25.12 |
Molina Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.47 | Professional | None | $10.00 | $10.00 | $10.47 |
Oscar Health Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $691.83 | Facility | None | $48.98 | $48.98 | $691.83 |
Providence Setting Facility Modifier None Typical Low $10.00 Median $14.45 Typical High $15.49 | Facility | None | $10.00 | $14.45 | $15.49 |
Providence Setting Professional Modifier None Typical Low $9.77 Median $14.13 Typical High $14.79 | Professional | None | $9.77 | $14.13 | $14.79 |
United Setting Professional Modifier None Typical Low $10.23 Median $12.02 Typical High $14.79 | Professional | None | $10.23 | $12.02 | $14.79 |
Wellpoint Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
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 $5.01 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $2.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $1.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $5.01 | $5.01 | $5.01 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $2.00 | $2.00 | $2.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $1.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $1.00 |
Where Texas sits
The same service costs 5.6 times more in Alabama than in Kentucky. 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· 20th of 51
$16.98
AL $56.23KY $10.00
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.