How much rates vary
Facilitymedian $1 · 10th to 90th $1 to $251Professionalmedian $0 · 10th to 90th $0 to $7
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 $0.56 Median $0.56 Typical High $0.78 | Facility | None | $0.56 | $0.56 | $0.78 |
Aetna Setting Professional Modifier None Typical Low $0.52 Median $0.56 Typical High $0.65 | Professional | None | $0.52 | $0.56 | $0.65 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
BCBS Texas Setting Facility Modifier None Typical Low $0.71 Median $0.95 Typical High $2.40 | Facility | None | $0.71 | $0.95 | $2.40 |
BCBS Texas Setting Professional Modifier None Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | None | $0.42 | $0.42 | $0.42 |
Christus Setting Facility Modifier None Typical Low $1.17 Median $1.17 Typical High $1.17 | Facility | None | $1.17 | $1.17 | $1.17 |
Cigna Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | None | $0.45 | $0.45 | $0.45 |
Lucent Health Setting Professional Modifier None Typical Low $4.47 Median $6.76 Typical High $6.76 | Professional | None | $4.47 | $6.76 | $6.76 |
Moda Health Setting Facility Modifier None Typical Low $0.81 Median $2.04 Typical High $3,388.44 | Facility | None | $0.81 | $2.04 | $3,388.44 |
Moda Health Setting Professional Modifier None Typical Low $0.54 Median $0.58 Typical High $0.72 | Professional | None | $0.54 | $0.58 | $0.72 |
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 $0.58 Median $0.89 Typical High $0.93 | Facility | None | $0.58 | $0.89 | $0.93 |
Providence Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | None | $0.45 | $0.45 | $0.45 |
United Setting Professional Modifier None Typical Low $0.31 Median $0.40 Typical High $0.52 | Professional | None | $0.31 | $0.40 | $0.52 |
Wellpoint Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $0.38 | Professional | None | $0.38 | $0.38 | $0.38 |
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 $0.27 Median $0.28 Typical High $0.38 | Professional | 52 · Reduced service | $0.27 | $0.28 | $0.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.12 Typical High $0.15 | Professional | 53 · Discontinued | $0.11 | $0.12 | $0.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.09 Typical High $0.11 | Professional | 55 · Aftercare only | $0.08 | $0.09 | $0.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.06 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.05 | $0.06 | $0.08 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | Q6 · Substitute physician, paid per time | $44.67 | $44.67 | $44.67 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.27 Median $0.29 Typical High $0.35 | Professional | 52 · Reduced service | $0.27 | $0.29 | $0.35 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.12 Typical High $0.14 | Professional | 53 · Discontinued | $0.11 | $0.12 | $0.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.09 Typical High $0.11 | Professional | 55 · Aftercare only | $0.08 | $0.09 | $0.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.06 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.05 | $0.06 | $0.07 |
Where Texas sits
The same service costs 2.6 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· 34th of 51
$0.45
HI $0.98UT $0.37
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.