How much rates vary
Facilitymedian $3 · 10th to 90th $1 to $5Professionalmedian $1 · 10th to 90th $1 to $1
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 $1.38 Median $2.04 Typical High $2.82 | Facility | None | $1.38 | $2.04 | $2.82 |
Aetna Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.51 | Professional | None | $1.38 | $1.38 | $1.51 |
BCBS Texas Setting Facility Modifier None Typical Low $1.07 Median $2.63 Typical High $4.90 | Facility | None | $1.07 | $2.63 | $4.90 |
BCBS Texas Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | None | $1.20 | $1.20 | $1.20 |
Cigna Setting Facility Modifier None Typical Low $1.41 Median $2.57 Typical High $4.47 | Facility | None | $1.41 | $2.57 | $4.47 |
Cigna Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | None | $1.41 | $1.41 | $1.41 |
Moda Health Setting Facility Modifier None Typical Low $1.29 Median $1.70 Typical High $3.09 | Facility | None | $1.29 | $1.70 | $3.09 |
Moda Health Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.41 | Professional | None | $1.29 | $1.29 | $1.41 |
Molina Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Providence Setting Facility Modifier None Typical Low $1.38 Median $1.95 Typical High $12.02 | Facility | None | $1.38 | $1.95 | $12.02 |
Providence Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | None | $1.41 | $1.41 | $1.41 |
United Setting Facility Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Facility | None | $1.38 | $1.38 | $1.38 |
United Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Wellpoint Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
12 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 Facility Modifier 52 · Reduced service Typical Low $0.69 Median $1.02 Typical High $1.41 | Facility | 52 · Reduced service | $0.69 | $1.02 | $1.41 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.28 Median $0.41 Typical High $0.56 | Facility | 53 · Discontinued | $0.28 | $0.41 | $0.56 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.21 Median $0.31 Typical High $0.42 | Facility | 55 · Aftercare only | $0.21 | $0.31 | $0.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.20 Typical High $0.28 | Facility | 56 · Pre-op care only | $0.14 | $0.20 | $0.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.69 Median $0.71 Typical High $0.76 | Professional | 52 · Reduced service | $0.69 | $0.71 | $0.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $0.30 | Professional | 53 · Discontinued | $0.28 | $0.28 | $0.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.23 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.65 Median $0.65 Typical High $0.68 | Professional | 52 · Reduced service | $0.65 | $0.65 | $0.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.26 Typical High $0.27 | Professional | 53 · Discontinued | $0.26 | $0.26 | $0.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.20 Typical High $0.20 | Professional | 55 · Aftercare only | $0.19 | $0.20 | $0.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.13 |
Where Texas sits
The same service costs 1.7 times more in Arizona than in Iowa. 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· 3rd of 51
$1.91
AZ $2.24IA $1.29
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.