How much rates vary
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 $0.62 Median $0.62 Typical High $0.68 | Facility | None | $0.62 | $0.62 | $0.68 |
Aetna Setting Professional Modifier None Typical Low $0.59 Median $0.63 Typical High $0.71 | Professional | None | $0.59 | $0.63 | $0.71 |
BCBS Texas Setting Facility Modifier None Typical Low $0.78 Median $1.10 Typical High $2.69 | Facility | None | $0.78 | $1.10 | $2.69 |
BCBS Texas Setting Professional Modifier None Typical Low $0.46 Median $0.46 Typical High $0.46 | Professional | None | $0.46 | $0.46 | $0.46 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
Lucent Health Setting Professional Modifier None Typical Low $4.79 Median $7.24 Typical High $7.24 | Professional | None | $4.79 | $7.24 | $7.24 |
Moda Health Setting Facility Modifier None Typical Low $0.62 Median $0.89 Typical High $1.00 | Facility | None | $0.62 | $0.89 | $1.00 |
Moda Health Setting Professional Modifier None Typical Low $0.59 Median $0.63 Typical High $0.78 | Professional | None | $0.59 | $0.63 | $0.78 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Providence Setting Facility Modifier None Typical Low $0.63 Median $0.98 Typical High $1.02 | Facility | None | $0.63 | $0.98 | $1.02 |
Providence Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | None | $0.49 | $0.49 | $0.49 |
United Setting Professional Modifier None Typical Low $0.34 Median $0.43 Typical High $0.56 | Professional | None | $0.34 | $0.43 | $0.56 |
Wellpoint Setting Professional Modifier None Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | None | $0.42 | $0.42 | $0.42 |
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 $0.28 Median $0.32 Typical High $0.41 | Professional | 52 · Reduced service | $0.28 | $0.32 | $0.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.13 Typical High $0.16 | Professional | 53 · Discontinued | $0.12 | $0.13 | $0.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.12 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.29 Median $0.32 Typical High $0.38 | Professional | 52 · Reduced service | $0.29 | $0.32 | $0.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.13 Typical High $0.15 | Professional | 53 · Discontinued | $0.12 | $0.13 | $0.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.12 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.08 |
Where Texas sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 26th of 51
$0.56
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.