How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $3Professionalmedian $1 · 10th to 90th $1 to $20
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 $1.70 Median $1.70 Typical High $1.82 | Facility | None | $1.70 | $1.70 | $1.82 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $1.70 Typical High $2.09 | Professional | None | $1.58 | $1.70 | $2.09 |
Ambetter Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.74 | Professional | None | $1.58 | $1.58 | $1.74 |
BCBS Texas Setting Facility Modifier None Typical Low $1.38 Median $1.48 Typical High $1.66 | Facility | None | $1.38 | $1.48 | $1.66 |
BCBS Texas Setting Professional Modifier None Typical Low $1.23 Median $1.38 Typical High $1.38 | Professional | None | $1.23 | $1.38 | $1.38 |
Christus Setting Facility Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Facility | None | $2.63 | $2.63 | $2.63 |
Cigna Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $1.66 | Facility | None | $1.55 | $1.55 | $1.66 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.55 | Professional | None | $1.32 | $1.32 | $1.55 |
Lucent Health Setting Professional Modifier None Typical Low $13.18 Median $19.95 Typical High $19.95 | Professional | None | $13.18 | $19.95 | $19.95 |
Moda Health Setting Facility Modifier None Typical Low $0.71 Median $1.70 Typical High $2.63 | Facility | None | $0.71 | $1.70 | $2.63 |
Moda Health Setting Professional Modifier None Typical Low $1.58 Median $1.70 Typical High $2.24 | Professional | None | $1.58 | $1.70 | $2.24 |
Molina Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $81.28 | Professional | None | $1.45 | $1.45 | $81.28 |
Providence Setting Facility Modifier None Typical Low $1.12 Median $1.55 Typical High $2.63 | Facility | None | $1.12 | $1.55 | $2.63 |
Providence Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.55 | Professional | None | $1.32 | $1.32 | $1.55 |
United Setting Professional Modifier None Typical Low $0.85 Median $1.15 Typical High $1.58 | Professional | None | $0.85 | $1.15 | $1.58 |
Wellpoint Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
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 $0.79 Median $0.85 Typical High $1.07 | Professional | 52 · Reduced service | $0.79 | $0.85 | $1.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.31 Median $0.34 Typical High $0.44 | Professional | 53 · Discontinued | $0.31 | $0.34 | $0.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.26 Typical High $0.33 | Professional | 55 · Aftercare only | $0.24 | $0.26 | $0.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.17 Typical High $0.22 | Professional | 56 · Pre-op care only | $0.16 | $0.17 | $0.22 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.79 Median $0.85 Typical High $1.07 | Professional | 52 · Reduced service | $0.79 | $0.85 | $1.07 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.31 Median $0.34 Typical High $0.42 | Professional | 53 · Discontinued | $0.31 | $0.34 | $0.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.26 Typical High $0.32 | Professional | 55 · Aftercare only | $0.24 | $0.26 | $0.32 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.17 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.16 | $0.17 | $0.21 |
Where Texas sits
The same service costs 2.3 times more in Kansas than in New Jersey. 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· 34th of 51
$1.55
KS $3.09NJ $1.32
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.