How much rates vary
Facilitymedian $7 · 10th to 90th $5 to $12Professionalmedian $7 · 10th to 90th $5 to $91
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 $7.76 Median $7.76 Typical High $8.51 | Facility | None | $7.76 | $7.76 | $8.51 |
Aetna Setting Professional Modifier None Typical Low $7.24 Median $7.76 Typical High $9.77 | Professional | None | $7.24 | $7.76 | $9.77 |
Ambetter Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $7.59 | Professional | None | $6.92 | $6.92 | $7.59 |
BCBS Texas Setting Facility Modifier None Typical Low $6.31 Median $6.76 Typical High $21.88 | Facility | None | $6.31 | $6.76 | $21.88 |
BCBS Texas Setting Professional Modifier None Typical Low $5.62 Median $6.31 Typical High $6.31 | Professional | None | $5.62 | $6.31 | $6.31 |
Baylor Scott & White Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $12.02 | Professional | None | $9.12 | $9.12 | $12.02 |
Christus Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.59 | Facility | None | $7.08 | $7.08 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $7.08 | Professional | None | $6.03 | $6.03 | $7.08 |
Lucent Health Setting Professional Modifier None Typical Low $60.26 Median $91.20 Typical High $91.20 | Professional | None | $60.26 | $91.20 | $91.20 |
Moda Health Setting Facility Modifier None Typical Low $3.24 Median $7.76 Typical High $12.02 | Facility | None | $3.24 | $7.76 | $12.02 |
Moda Health Setting Professional Modifier None Typical Low $7.24 Median $7.76 Typical High $10.23 | Professional | None | $7.24 | $7.76 | $10.23 |
Molina Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $81.28 | Professional | None | $6.76 | $6.76 | $81.28 |
Providence Setting Facility Modifier None Typical Low $5.13 Median $7.08 Typical High $12.02 | Facility | None | $5.13 | $7.08 | $12.02 |
Providence Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $7.08 | Professional | None | $6.03 | $6.03 | $7.08 |
United Setting Professional Modifier None Typical Low $3.89 Median $5.37 Typical High $7.24 | Professional | None | $3.89 | $5.37 | $7.24 |
Wellpoint Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
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 $3.63 Median $3.89 Typical High $4.79 | Professional | 52 · Reduced service | $3.63 | $3.89 | $4.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.55 Typical High $1.95 | Professional | 53 · Discontinued | $1.45 | $1.55 | $1.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.17 Typical High $1.45 | Professional | 55 · Aftercare only | $1.07 | $1.17 | $1.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $0.78 Typical High $0.98 | Professional | 56 · Pre-op care only | $0.72 | $0.78 | $0.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.63 Median $3.89 Typical High $4.90 | Professional | 52 · Reduced service | $3.63 | $3.89 | $4.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.55 Typical High $1.95 | Professional | 53 · Discontinued | $1.45 | $1.55 | $1.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.17 Typical High $1.45 | Professional | 55 · Aftercare only | $1.07 | $1.17 | $1.45 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $0.78 Typical High $0.98 | Professional | 56 · Pre-op care only | $0.72 | $0.78 | $0.98 |
Where Texas sits
The same service costs 2.1 times more in Hawaii 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
$7.08
HI $12.59DE $6.03
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.