How much rates vary
Facilitymedian $23 · 10th to 90th $8 to $46Professionalmedian $4 · 10th to 90th $3 to $28
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 $3.47 Median $3.47 Typical High $3.89 | Facility | None | $3.47 | $3.47 | $3.89 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.47 Typical High $3.89 | Professional | None | $3.02 | $3.47 | $3.89 |
BCBS Texas Setting Facility Modifier None Typical Low $10.23 Median $25.70 Typical High $48.98 | Facility | None | $10.23 | $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 $3.72 Median $8.71 Typical High $11.75 | Facility | None | $3.72 | $8.71 | $11.75 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Lucent Health Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $38.02 | Professional | None | $28.18 | $28.18 | $38.02 |
Moda Health Setting Facility Modifier None Typical Low $3.24 Median $4.90 Typical High $12.88 | Facility | None | $3.24 | $4.90 | $12.88 |
Moda Health Setting Professional Modifier None Typical Low $3.02 Median $3.47 Typical High $3.89 | Professional | None | $3.02 | $3.47 | $3.89 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $44.67 | Professional | None | $30.20 | $30.20 | $44.67 |
Providence Setting Facility Modifier None Typical Low $3.72 Median $5.13 Typical High $31.62 | Facility | None | $3.72 | $5.13 | $31.62 |
Providence Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
United Setting Professional Modifier None Typical Low $2.34 Median $2.82 Typical High $9.55 | Professional | None | $2.34 | $2.82 | $9.55 |
Wellpoint Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | None | $4.17 | $4.17 | $4.17 |
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 $1.51 Median $1.74 Typical High $1.95 | Professional | 52 · Reduced service | $1.51 | $1.74 | $1.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.60 Median $0.69 Typical High $0.78 | Professional | 53 · Discontinued | $0.60 | $0.69 | $0.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.52 Typical High $0.58 | Professional | 55 · Aftercare only | $0.45 | $0.52 | $0.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.35 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.30 | $0.35 | $0.39 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.51 Median $1.74 Typical High $1.82 | Professional | 52 · Reduced service | $1.51 | $1.74 | $1.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.60 Median $0.69 Typical High $0.74 | Professional | 53 · Discontinued | $0.60 | $0.69 | $0.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.52 Typical High $0.55 | Professional | 55 · Aftercare only | $0.45 | $0.52 | $0.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.35 Typical High $0.37 | Professional | 56 · Pre-op care only | $0.30 | $0.35 | $0.37 |
Where Texas sits
The same service costs 4.6 times more in Ohio than in Hawaii. 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· 2nd of 51
$9.55
OH $11.48HI $2.51
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.