How much rates vary
Facilitymedian $8 · 10th to 90th $8 to $8Professionalmedian $0 · 10th to 90th $0 to $2
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 $0.14 Median $0.15 Typical High $0.15 | Facility | None | $0.14 | $0.15 | $0.15 |
Aetna Setting Professional Modifier None Typical Low $0.14 Median $0.15 Typical High $0.15 | Professional | None | $0.14 | $0.15 | $0.15 |
Ambetter Setting Professional Modifier None Typical Low $15.85 Median $19.95 Typical High $22.91 | Professional | None | $15.85 | $19.95 | $22.91 |
BCBS Texas Setting Facility Modifier None Typical Low $0.12 Median $0.12 Typical High $0.13 | Facility | None | $0.12 | $0.12 | $0.13 |
BCBS Texas Setting Professional Modifier None Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | None | $0.22 | $0.22 | $0.22 |
Christus Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Facility | None | $7.94 | $7.94 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | None | $0.30 | $0.30 | $0.30 |
Lucent Health Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
Moda Health Setting Facility Modifier None Typical Low $0.15 Median $0.15 Typical High $457.09 | Facility | None | $0.15 | $0.15 | $457.09 |
Moda Health Setting Professional Modifier None Typical Low $0.14 Median $0.15 Typical High $0.15 | Professional | None | $0.14 | $0.15 | $0.15 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $0.15 Median $0.15 Typical High $0.21 | Facility | None | $0.15 | $0.15 | $0.21 |
Providence Setting Professional Modifier None Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | None | $0.30 | $0.30 | $0.30 |
United Setting Professional Modifier None Typical Low $0.17 Median $0.41 Typical High $5.37 | Professional | None | $0.17 | $0.41 | $5.37 |
Wellpoint Setting Professional Modifier None Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | None | $0.14 | $0.14 | $0.14 |
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 $0.08 Median $0.08 Typical High $0.08 | Professional | 52 · Reduced service | $0.08 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 53 · Discontinued | $0.03 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 52 · Reduced service | $0.08 | $0.08 | $0.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 53 · Discontinued | $0.03 | $0.03 | $0.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Where Texas sits
The same service costs 1318.3 times more in Montana than in Missouri. 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· 27th of 51
$0.22
MT $79.43MO $0.06
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.