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 $1.58 Median $1.58 Typical High $1.74 | Facility | None | $1.58 | $1.58 | $1.74 |
Aetna Setting Professional Modifier None Typical Low $1.48 Median $1.62 Typical High $2.09 | Professional | None | $1.48 | $1.62 | $2.09 |
BCBS Texas Setting Facility Modifier None Typical Low $1.95 Median $2.95 Typical High $6.92 | Facility | None | $1.95 | $2.95 | $6.92 |
BCBS Texas Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.17 | Professional | None | $1.17 | $1.17 | $1.17 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.12 Typical High $1.12 | Professional | None | $1.02 | $1.12 | $1.12 |
Lucent Health Setting Professional Modifier None Typical Low $12.59 Median $18.62 Typical High $18.62 | Professional | None | $12.59 | $18.62 | $18.62 |
Moda Health Setting Facility Modifier None Typical Low $1.58 Median $2.51 Typical High $2.57 | Facility | None | $1.58 | $2.51 | $2.57 |
Moda Health Setting Professional Modifier None Typical Low $1.51 Median $1.62 Typical High $2.14 | Professional | None | $1.51 | $1.62 | $2.14 |
Molina Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.24 | Professional | None | $1.95 | $1.95 | $2.24 |
Providence Setting Facility Modifier None Typical Low $1.58 Median $2.51 Typical High $2.57 | Facility | None | $1.58 | $2.51 | $2.57 |
Providence Setting Professional Modifier None Typical Low $1.02 Median $1.12 Typical High $1.12 | Professional | None | $1.02 | $1.12 | $1.12 |
United Setting Professional Modifier None Typical Low $0.87 Median $1.15 Typical High $1.66 | Professional | None | $0.87 | $1.15 | $1.66 |
Wellpoint Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
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 $0.74 Median $0.81 Typical High $1.02 | Professional | 52 · Reduced service | $0.74 | $0.81 | $1.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.30 Median $0.32 Typical High $0.41 | Professional | 53 · Discontinued | $0.30 | $0.32 | $0.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.22 Median $0.24 Typical High $0.31 | Professional | 55 · Aftercare only | $0.22 | $0.24 | $0.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.16 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.15 | $0.16 | $0.21 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.76 Median $0.81 Typical High $1.00 | Professional | 52 · Reduced service | $0.76 | $0.81 | $1.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.30 Median $0.32 Typical High $0.40 | Professional | 53 · Discontinued | $0.30 | $0.32 | $0.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.22 Median $0.24 Typical High $0.30 | Professional | 55 · Aftercare only | $0.22 | $0.24 | $0.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.16 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.15 | $0.16 | $0.20 |
Where Texas sits
The same service costs 4.6 times more in Rhode Island 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· 46th of 51
$1.17
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.