How much rates vary
Facilitymedian $6 · 10th to 90th $1 to $17Professionalmedian $11 · 10th to 90th $6 to $11
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 $11.22 Median $16.98 Typical High $24.55 | Facility | None | $11.22 | $16.98 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $12.30 | Professional | None | $11.22 | $11.22 | $12.30 |
BCBS Texas Setting Facility Modifier None Typical Low $0.93 Median $2.19 Typical High $7.24 | Facility | None | $0.93 | $2.19 | $7.24 |
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 |
Christus Setting Facility Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Facility | None | $6.31 | $6.31 | $6.31 |
Cigna Setting Facility Modifier None Typical Low $11.22 Median $20.89 Typical High $35.48 | Facility | None | $11.22 | $20.89 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
Moda Health Setting Facility Modifier None Typical Low $8.13 Median $12.30 Typical High $39.81 | Facility | None | $8.13 | $12.30 | $39.81 |
Moda Health Setting Professional Modifier None Typical Low $11.22 Median $11.48 Typical High $11.75 | Professional | None | $11.22 | $11.48 | $11.75 |
Molina Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
Providence Setting Facility Modifier None Typical Low $7.59 Median $13.49 Typical High $95.50 | Facility | None | $7.59 | $13.49 | $95.50 |
Providence Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
United Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
Wellpoint Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
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 $5.62 Median $9.12 Typical High $12.30 | Facility | 52 · Reduced service | $5.62 | $9.12 | $12.30 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.24 Median $3.63 Typical High $4.90 | Facility | 53 · Discontinued | $2.24 | $3.63 | $4.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.66 Median $2.69 Typical High $3.72 | Facility | 55 · Aftercare only | $1.66 | $2.69 | $3.72 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.82 Typical High $2.45 | Facility | 56 · Pre-op care only | $1.12 | $1.82 | $2.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.62 Median $5.62 Typical High $6.17 | Professional | 52 · Reduced service | $5.62 | $5.62 | $6.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.24 Typical High $2.45 | Professional | 53 · Discontinued | $2.24 | $2.24 | $2.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.70 Typical High $1.82 | Professional | 55 · Aftercare only | $1.66 | $1.70 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.23 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.62 Median $5.75 Typical High $5.89 | Professional | 52 · Reduced service | $5.62 | $5.75 | $5.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $2.34 | Professional | 53 · Discontinued | $2.29 | $2.29 | $2.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.74 Typical High $1.78 | Professional | 55 · Aftercare only | $1.70 | $1.74 | $1.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.15 Typical High $1.17 | Professional | 56 · Pre-op care only | $1.12 | $1.15 | $1.17 |
Where Texas sits
The same service costs 3.3 times more in Alaska than in Texas. 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· 51st of 51
$6.31
AK $20.89TX $6.31
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.