How much rates vary
Facilitymedian $58 · 10th to 90th $4 to $162Professionalmedian $4 · 10th to 90th $3 to $9
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 $3.55 Median $4.27 Typical High $5.25 | Facility | None | $3.55 | $4.27 | $5.25 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $4.27 Typical High $5.25 | Professional | None | $3.55 | $4.27 | $5.25 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.78 Median $2.14 Typical High $2.40 | Professional | 52 · Reduced service | $1.78 | $2.14 | $2.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.85 Typical High $0.95 | Professional | 53 · Discontinued | $0.71 | $0.85 | $0.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.65 Typical High $0.72 | Professional | 55 · Aftercare only | $0.52 | $0.65 | $0.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.43 Typical High $0.48 | Professional | 56 · Pre-op care only | $0.36 | $0.43 | $0.48 |
Ambetter Setting Professional Modifier None Typical Low $3.31 Median $4.17 Typical High $5.01 | Professional | None | $3.31 | $4.17 | $5.01 |
BCBS Texas Setting Facility Modifier None Typical Low $39.81 Median $97.72 Typical High $177.83 | Facility | None | $39.81 | $97.72 | $177.83 |
BCBS Texas Setting Professional Modifier None Typical Low $2.69 Median $3.72 Typical High $4.90 | Professional | None | $2.69 | $3.72 | $4.90 |
Baylor Scott & White Setting Professional Modifier None Typical Low $4.79 Median $4.90 Typical High $5.75 | Professional | None | $4.79 | $4.90 | $5.75 |
Christus Setting Facility Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Facility | None | $4.47 | $4.47 | $4.47 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.98 Typical High $5.62 | Professional | None | $3.02 | $3.98 | $5.62 |
Health Smart Setting Professional Modifier None Typical Low $4.47 Median $5.37 Typical High $6.61 | Professional | None | $4.47 | $5.37 | $6.61 |
Lucent Health Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $44.67 | Professional | None | $29.51 | $29.51 | $44.67 |
Moda Health Setting Facility Modifier None Typical Low $4.27 Median $5.50 Typical High $107.15 | Facility | None | $4.27 | $5.50 | $107.15 |
Moda Health Setting Professional Modifier None Typical Low $3.55 Median $4.27 Typical High $5.37 | Professional | None | $3.55 | $4.27 | $5.37 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.78 Median $2.14 Typical High $2.40 | Professional | 52 · Reduced service | $1.78 | $2.14 | $2.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.85 Typical High $0.95 | Professional | 53 · Discontinued | $0.71 | $0.85 | $0.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.65 Typical High $0.72 | Professional | 55 · Aftercare only | $0.52 | $0.65 | $0.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.43 Typical High $0.48 | Professional | 56 · Pre-op care only | $0.36 | $0.43 | $0.48 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Oscar Health Setting Facility Modifier None Typical Low $46.77 Median $208.93 Typical High $208.93 | Facility | None | $46.77 | $208.93 | $208.93 |
Oscar Health Setting Professional Modifier None Typical Low $4.79 Median $9.33 Typical High $11.48 | Professional | None | $4.79 | $9.33 | $11.48 |
Providence Setting Facility Modifier None Typical Low $3.55 Median $4.57 Typical High $6.46 | Facility | None | $3.55 | $4.57 | $6.46 |
Providence Setting Professional Modifier None Typical Low $3.02 Median $3.98 Typical High $5.50 | Professional | None | $3.02 | $3.98 | $5.50 |
United Setting Facility Modifier None Typical Low $56.23 Median $58.88 Typical High $77.62 | Facility | None | $56.23 | $58.88 | $77.62 |
United Setting Professional Modifier None Typical Low $3.80 Median $5.25 Typical High $8.13 | Professional | None | $3.80 | $5.25 | $8.13 |
Wellpoint Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
5 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 33 · Preventive service | $4.07 | $4.07 | $4.07 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $4.07 Median $4.47 Typical High $4.90 | Professional | 59 · Distinct service | $4.07 | $4.47 | $4.90 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | Q6 · Substitute physician, paid per time | $4.79 | $4.79 | $4.79 |
Ambetter Setting Professional Modifier XU · Unusual separate service Typical Low $4.07 Median $4.79 Typical High $4.79 | Professional | XU · Unusual separate service | $4.07 | $4.79 | $4.79 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $4.90 Median $7.24 Typical High $31.62 | Professional | 59 · Distinct service | $4.90 | $7.24 | $31.62 |
Where Texas sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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· 48th of 51
$4.27
ND $8.71NM $3.24
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.