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 $5.62 Median $9.12 Typical High $12.30 | Facility | None | $5.62 | $9.12 | $12.30 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $2.82 Median $4.47 Typical High $6.17 | Facility | 52 · Reduced service | $2.82 | $4.47 | $6.17 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.12 Median $1.82 Typical High $2.45 | Facility | 53 · Discontinued | $1.12 | $1.82 | $2.45 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $6.17 | Professional | None | $5.62 | $5.62 | $6.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.82 Median $2.82 Typical High $3.09 | Professional | 52 · Reduced service | $2.82 | $2.82 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.12 Typical High $1.23 | Professional | 53 · Discontinued | $1.12 | $1.12 | $1.23 |
BCBS Texas Setting Facility Modifier None Typical Low $5.50 Median $13.49 Typical High $25.12 | Facility | None | $5.50 | $13.49 | $25.12 |
BCBS Texas Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | None | $5.89 | $5.89 | $5.89 |
Cigna Setting Facility Modifier None Typical Low $5.62 Median $10.47 Typical High $17.78 | Facility | None | $5.62 | $10.47 | $17.78 |
Cigna Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Moda Health Setting Facility Modifier None Typical Low $5.62 Median $7.41 Typical High $13.80 | Facility | None | $5.62 | $7.41 | $13.80 |
Moda Health Setting Professional Modifier None Typical Low $5.62 Median $5.75 Typical High $6.17 | Professional | None | $5.62 | $5.75 | $6.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.82 Median $2.88 Typical High $2.95 | Professional | 52 · Reduced service | $2.82 | $2.88 | $2.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.15 Typical High $1.17 | Professional | 53 · Discontinued | $1.12 | $1.15 | $1.17 |
Molina Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
Providence Setting Facility Modifier None Typical Low $5.62 Median $7.94 Typical High $47.86 | Facility | None | $5.62 | $7.94 | $47.86 |
Providence Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
United Setting Facility Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Facility | None | $5.62 | $5.62 | $5.62 |
United Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Wellpoint Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
2 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 55 · Aftercare only Typical Low $0.83 Median $0.85 Typical High $0.91 | Professional | 55 · Aftercare only | $0.83 | $0.85 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $0.74 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $0.74 |
Where Texas sits
The same service costs 1.7 times more in Arizona than in Vermont. 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
$8.51
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.