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 $19.05 Median $19.05 Typical High $28.18 | Facility | None | $19.05 | $19.05 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $25.70 Typical High $30.20 | Professional | None | $19.05 | $25.70 | $30.20 |
BCBS Texas Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $25.12 | Professional | None | $19.95 | $19.95 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Lucent Health Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $199.53 | Professional | None | $151.36 | $199.53 | $199.53 |
Moda Health Setting Facility Modifier None Typical Low $19.05 Median $25.70 Typical High $36.31 | Facility | None | $19.05 | $25.70 | $36.31 |
Moda Health Setting Professional Modifier None Typical Low $19.05 Median $25.70 Typical High $30.20 | Professional | None | $19.05 | $25.70 | $30.20 |
Molina Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Providence Setting Facility Modifier None Typical Low $19.05 Median $28.18 Typical High $47.86 | Facility | None | $19.05 | $28.18 | $47.86 |
Providence Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
United Setting Professional Modifier None Typical Low $19.50 Median $24.55 Typical High $37.15 | Professional | None | $19.50 | $24.55 | $37.15 |
Wellpoint Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
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 $9.55 Median $12.88 Typical High $15.14 | Professional | 52 · Reduced service | $9.55 | $12.88 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $5.13 Typical High $6.03 | Professional | 53 · Discontinued | $3.89 | $5.13 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $3.80 Typical High $4.57 | Professional | 55 · Aftercare only | $2.88 | $3.80 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.57 Typical High $3.02 | Professional | 56 · Pre-op care only | $1.95 | $2.57 | $3.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $9.55 Median $12.88 Typical High $15.14 | Professional | 52 · Reduced service | $9.55 | $12.88 | $15.14 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $5.13 Typical High $6.03 | Professional | 53 · Discontinued | $3.89 | $5.13 | $6.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $3.80 Typical High $4.57 | Professional | 55 · Aftercare only | $2.88 | $3.80 | $4.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.57 Typical High $3.02 | Professional | 56 · Pre-op care only | $1.95 | $2.57 | $3.02 |
Where Texas sits
The same service costs 2.7 times more in Alaska than in Connecticut. 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· 44th of 51
$21.88
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.