How much rates vary
Facilitymedian $68 · 10th to 90th $2 to $68Professionalmedian $2 · 10th to 90th $2 to $30
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 $2.51 Median $2.51 Typical High $2.75 | Facility | None | $2.51 | $2.51 | $2.75 |
Aetna Setting Professional Modifier None Typical Low $2.34 Median $2.57 Typical High $3.16 | Professional | None | $2.34 | $2.57 | $3.16 |
Ambetter Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
BCBS Texas Setting Facility Modifier None Typical Low $2.04 Median $2.24 Typical High $2.45 | Facility | None | $2.04 | $2.24 | $2.45 |
BCBS Texas Setting Professional Modifier None Typical Low $1.86 Median $2.09 Typical High $2.09 | Professional | None | $1.86 | $2.09 | $2.09 |
Baylor Scott & White Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.98 | Professional | None | $3.02 | $3.02 | $3.98 |
Christus Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $2.34 Median $2.34 Typical High $2.51 | Facility | None | $2.34 | $2.34 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.34 | Professional | None | $2.00 | $2.00 | $2.34 |
Lucent Health Setting Professional Modifier None Typical Low $19.95 Median $29.51 Typical High $29.51 | Professional | None | $19.95 | $29.51 | $29.51 |
Moda Health Setting Facility Modifier None Typical Low $1.07 Median $2.51 Typical High $3.98 | Facility | None | $1.07 | $2.51 | $3.98 |
Moda Health Setting Professional Modifier None Typical Low $2.34 Median $2.57 Typical High $3.39 | Professional | None | $2.34 | $2.57 | $3.39 |
Molina Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $81.28 | Professional | None | $2.19 | $2.19 | $81.28 |
Providence Setting Facility Modifier None Typical Low $1.66 Median $2.34 Typical High $3.98 | Facility | None | $1.66 | $2.34 | $3.98 |
Providence Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.34 | Professional | None | $2.00 | $2.00 | $2.34 |
United Setting Professional Modifier None Typical Low $1.26 Median $1.74 Typical High $2.34 | Professional | None | $1.26 | $1.74 | $2.34 |
Wellpoint Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | None | $2.04 | $2.04 | $2.04 |
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 $1.17 Median $1.29 Typical High $1.58 | Professional | 52 · Reduced service | $1.17 | $1.29 | $1.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.47 Median $0.51 Typical High $0.66 | Professional | 53 · Discontinued | $0.47 | $0.51 | $0.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.35 Median $0.38 Typical High $0.50 | Professional | 55 · Aftercare only | $0.35 | $0.38 | $0.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.24 Median $0.26 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.24 | $0.26 | $0.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.17 Median $1.29 Typical High $1.58 | Professional | 52 · Reduced service | $1.17 | $1.29 | $1.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.47 Median $0.51 Typical High $0.63 | Professional | 53 · Discontinued | $0.47 | $0.51 | $0.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.35 Median $0.38 Typical High $0.48 | Professional | 55 · Aftercare only | $0.35 | $0.38 | $0.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.24 Median $0.26 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.24 | $0.26 | $0.32 |
Where Texas sits
The same service costs 2.2 times more in Kansas than in Delaware. 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· 35th of 51
$2.34
KS $4.47DE $2.00
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.