How much rates vary
Facilitymedian $6 · 10th to 90th $4 to $17Professionalmedian $4 · 10th to 90th $3 to $51
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 $4.27 Median $4.27 Typical High $4.68 | Facility | None | $4.27 | $4.27 | $4.68 |
Aetna Setting Professional Modifier None Typical Low $3.98 Median $4.37 Typical High $5.37 | Professional | None | $3.98 | $4.37 | $5.37 |
Ambetter Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $4.07 | Professional | None | $3.80 | $3.80 | $4.07 |
BCBS Texas Setting Facility Modifier None Typical Low $5.25 Median $7.76 Typical High $18.62 | Facility | None | $5.25 | $7.76 | $18.62 |
BCBS Texas Setting Professional Modifier None Typical Low $3.16 Median $3.55 Typical High $3.55 | Professional | None | $3.16 | $3.55 | $3.55 |
Christus Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Facility | None | $6.76 | $6.76 | $6.76 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $4.27 | Facility | None | $3.98 | $3.98 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.98 | Professional | None | $3.39 | $3.39 | $3.98 |
Lucent Health Setting Professional Modifier None Typical Low $33.88 Median $51.29 Typical High $51.29 | Professional | None | $33.88 | $51.29 | $51.29 |
Moda Health Setting Facility Modifier None Typical Low $1.82 Median $3.98 Typical High $6.76 | Facility | None | $1.82 | $3.98 | $6.76 |
Moda Health Setting Professional Modifier None Typical Low $3.98 Median $4.37 Typical High $5.75 | Professional | None | $3.98 | $4.37 | $5.75 |
Molina Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $81.28 | Professional | None | $3.72 | $3.72 | $81.28 |
Providence Setting Facility Modifier None Typical Low $2.82 Median $3.98 Typical High $6.76 | Facility | None | $2.82 | $3.98 | $6.76 |
Providence Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.98 | Professional | None | $3.39 | $3.39 | $3.98 |
United Setting Professional Modifier None Typical Low $2.19 Median $2.95 Typical High $4.07 | Professional | None | $2.19 | $2.95 | $4.07 |
Wellpoint Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
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 $2.00 Median $2.19 Typical High $2.69 | Professional | 52 · Reduced service | $2.00 | $2.19 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $0.87 Typical High $1.07 | Professional | 53 · Discontinued | $0.79 | $0.87 | $1.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.60 Median $0.66 Typical High $0.85 | Professional | 55 · Aftercare only | $0.60 | $0.66 | $0.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.40 Median $0.44 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.40 | $0.44 | $0.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.00 Median $2.19 Typical High $2.69 | Professional | 52 · Reduced service | $2.00 | $2.19 | $2.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $0.87 Typical High $1.07 | Professional | 53 · Discontinued | $0.79 | $0.87 | $1.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.60 Median $0.66 Typical High $0.81 | Professional | 55 · Aftercare only | $0.60 | $0.66 | $0.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.40 Median $0.44 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.40 | $0.44 | $0.54 |
Where Texas sits
The same service costs 2.1 times more in Kansas than in Alabama. 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· 29th of 51
$4.07
KS $7.08AL $3.39
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.