How much rates vary
Facilitymedian $6 · 10th to 90th $4 to $10Professionalmedian $6 · 10th to 90th $4 to $74
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 $6.31 Median $6.31 Typical High $6.92 | Facility | None | $6.31 | $6.31 | $6.92 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $6.31 Typical High $7.24 | Professional | None | $5.50 | $6.31 | $7.24 |
Ambetter Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $7.59 | Professional | None | $4.90 | $4.90 | $7.59 |
BCBS Texas Setting Facility Modifier None Typical Low $4.37 Median $4.68 Typical High $5.75 | Facility | None | $4.37 | $4.68 | $5.75 |
BCBS Texas Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Christus Setting Facility Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Facility | None | $9.77 | $9.77 | $9.77 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $7.24 | Facility | None | $5.75 | $5.75 | $7.24 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $5.75 | Professional | None | $4.90 | $4.90 | $5.75 |
Lucent Health Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $74.13 | Professional | None | $63.10 | $74.13 | $74.13 |
Moda Health Setting Facility Modifier None Typical Low $2.63 Median $6.31 Typical High $9.77 | Facility | None | $2.63 | $6.31 | $9.77 |
Moda Health Setting Professional Modifier None Typical Low $5.37 Median $6.31 Typical High $8.13 | Professional | None | $5.37 | $6.31 | $8.13 |
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 $4.17 Median $5.75 Typical High $9.77 | Facility | None | $4.17 | $5.75 | $9.77 |
Providence Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $5.75 | Professional | None | $4.90 | $4.90 | $5.75 |
United Setting Professional Modifier None Typical Low $3.09 Median $4.47 Typical High $5.89 | Professional | None | $3.09 | $4.47 | $5.89 |
Wellpoint Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | None | $4.07 | $4.07 | $4.07 |
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 $2.95 Median $3.16 Typical High $3.89 | Professional | 52 · Reduced service | $2.95 | $3.16 | $3.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.17 Median $1.26 Typical High $1.55 | Professional | 53 · Discontinued | $1.17 | $1.26 | $1.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.87 Median $0.95 Typical High $1.15 | Professional | 55 · Aftercare only | $0.87 | $0.95 | $1.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.58 Median $0.65 Typical High $0.78 | Professional | 56 · Pre-op care only | $0.58 | $0.65 | $0.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.95 Median $3.16 Typical High $3.89 | Professional | 52 · Reduced service | $2.95 | $3.16 | $3.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.17 Median $1.26 Typical High $1.55 | Professional | 53 · Discontinued | $1.17 | $1.26 | $1.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.87 Median $0.95 Typical High $1.15 | Professional | 55 · Aftercare only | $0.87 | $0.95 | $1.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.58 Median $0.65 Typical High $0.78 | Professional | 56 · Pre-op care only | $0.58 | $0.65 | $0.78 |
Where Texas sits
The same service costs 2.5 times more in Montana than in New Hampshire. 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· 30th of 51
$5.75
MT $10.23NH $4.07
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.