How much rates vary
Facilitymedian $51 · 10th to 90th $30 to $977Professionalmedian $22 · 10th to 90th $15 to $219
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 $28.18 Median $28.18 Typical High $30.90 | Facility | None | $28.18 | $28.18 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $28.18 Typical High $31.62 | Professional | None | $26.30 | $28.18 | $31.62 |
Ambetter Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
BCBS Texas Setting Facility Modifier None Typical Low $34.67 Median $51.29 Typical High $123.03 | Facility | None | $34.67 | $51.29 | $123.03 |
BCBS Texas Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Baylor Scott & White Setting Facility Modifier None Typical Low $28.18 Median $33.11 Typical High $724.44 | Facility | None | $28.18 | $33.11 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Lucent Health Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $331.13 | Professional | None | $218.78 | $331.13 | $331.13 |
Moda Health Setting Facility Modifier None Typical Low $24.55 Median $660.69 Typical High $2,511.89 | Facility | None | $24.55 | $660.69 | $2,511.89 |
Moda Health Setting Professional Modifier None Typical Low $26.30 Median $28.18 Typical High $31.62 | Professional | None | $26.30 | $28.18 | $31.62 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $37.15 | Professional | None | $32.36 | $32.36 | $37.15 |
Oscar Health Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Providence Setting Facility Modifier None Typical Low $28.18 Median $43.65 Typical High $45.71 | Facility | None | $28.18 | $43.65 | $45.71 |
Providence Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
United Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Wellpoint Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
9 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 $13.18 Median $14.13 Typical High $18.20 | Professional | 52 · Reduced service | $13.18 | $14.13 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.62 Typical High $7.24 | Professional | 53 · Discontinued | $5.25 | $5.62 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $4.27 Typical High $5.50 | Professional | 55 · Aftercare only | $3.89 | $4.27 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.82 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.63 | $2.82 | $3.63 |
Ambetter Setting Professional Modifier A1 · Dressing, 1 wound Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | A1 · Dressing, 1 wound | $30.90 | $30.90 | $30.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $14.13 Typical High $17.38 | Professional | 52 · Reduced service | $13.18 | $14.13 | $17.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.62 Typical High $6.92 | Professional | 53 · Discontinued | $5.25 | $5.62 | $6.92 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $4.27 Typical High $5.25 | Professional | 55 · Aftercare only | $3.89 | $4.27 | $5.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.82 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.63 | $2.82 | $3.47 |
Where Texas sits
The same service costs 3.2 times more in Hawaii than in Utah. 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· 31st of 51
$21.88
HI $47.86UT $15.14
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.