How much rates vary
Facilitymedian $25 · 10th to 90th $10 to $48Professionalmedian $10 · 10th to 90th $7 to $100
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 $8.91 Median $8.91 Typical High $10.00 | Facility | None | $8.91 | $8.91 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $8.91 Typical High $10.00 | Professional | None | $7.76 | $8.91 | $10.00 |
BCBS Texas Setting Facility Modifier None Typical Low $10.00 Median $25.70 Typical High $48.98 | Facility | None | $10.00 | $25.70 | $48.98 |
BCBS Texas Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Cigna Setting Facility Modifier None Typical Low $9.77 Median $22.91 Typical High $30.90 | Facility | None | $9.77 | $22.91 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Lucent Health Setting Professional Modifier None Typical Low $74.13 Median $100.00 Typical High $100.00 | Professional | None | $74.13 | $100.00 | $100.00 |
Moda Health Setting Facility Modifier None Typical Low $8.51 Median $10.00 Typical High $14.79 | Facility | None | $8.51 | $10.00 | $14.79 |
Moda Health Setting Professional Modifier None Typical Low $7.76 Median $8.91 Typical High $10.00 | Professional | None | $7.76 | $8.91 | $10.00 |
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 $9.77 Median $13.49 Typical High $83.18 | Facility | None | $9.77 | $13.49 | $83.18 |
Providence Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $5.75 Median $6.92 Typical High $10.00 | Professional | None | $5.75 | $6.92 | $10.00 |
Wellpoint Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
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 $3.89 Median $4.47 Typical High $5.01 | Professional | 52 · Reduced service | $3.89 | $4.47 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.55 Median $1.78 Typical High $2.04 | Professional | 53 · Discontinued | $1.55 | $1.78 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.15 Median $1.35 Typical High $1.51 | Professional | 55 · Aftercare only | $1.15 | $1.35 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $0.89 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.78 | $0.89 | $1.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.89 Median $4.47 Typical High $5.01 | Professional | 52 · Reduced service | $3.89 | $4.47 | $5.01 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.55 Median $1.78 Typical High $2.04 | Professional | 53 · Discontinued | $1.55 | $1.78 | $2.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.15 Median $1.35 Typical High $1.51 | Professional | 55 · Aftercare only | $1.15 | $1.35 | $1.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $0.89 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.78 | $0.89 | $1.00 |
Where Texas sits
The same service costs 46.8 times more in New York than in Arkansas. 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· 29th of 51
$9.77
NY $324AR $6.92
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.