How much rates vary
Facilitymedian $1 · 10th to 90th $0 to $2Professionalmedian $0 · 10th to 90th $0 to $0
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 $0.40 Median $0.55 Typical High $0.83 | Facility | None | $0.40 | $0.55 | $0.83 |
Aetna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.44 | Professional | None | $0.40 | $0.40 | $0.44 |
BCBS Texas Setting Facility Modifier None Typical Low $0.22 Median $0.54 Typical High $1.00 | Facility | None | $0.22 | $0.54 | $1.00 |
BCBS Texas Setting Professional Modifier None Typical Low $0.33 Median $0.33 Typical High $0.36 | Professional | None | $0.33 | $0.33 | $0.36 |
Baylor Scott & White Setting Facility Modifier None Typical Low $0.39 Median $0.68 Typical High $0.68 | Facility | None | $0.39 | $0.68 | $0.68 |
Cigna Setting Facility Modifier None Typical Low $0.40 Median $0.76 Typical High $1.29 | Facility | None | $0.40 | $0.76 | $1.29 |
Cigna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
Moda Health Setting Facility Modifier None Typical Low $0.52 Median $1.45 Typical High $5.13 | Facility | None | $0.52 | $1.45 | $5.13 |
Moda Health Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.43 | Professional | None | $0.39 | $0.39 | $0.43 |
Molina Setting Professional Modifier None Typical Low $0.39 Median $0.40 Typical High $0.41 | Professional | None | $0.39 | $0.40 | $0.41 |
Providence Setting Facility Modifier None Typical Low $0.39 Median $0.49 Typical High $3.39 | Facility | None | $0.39 | $0.49 | $3.39 |
Providence Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
United Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.39 | Professional | None | $0.39 | $0.39 | $0.39 |
Wellpoint Setting Professional Modifier None Typical Low $0.41 Median $0.41 Typical High $0.41 | Professional | None | $0.41 | $0.41 | $0.41 |
13 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 $0.20 Median $0.31 Typical High $0.42 | Facility | 52 · Reduced service | $0.20 | $0.31 | $0.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.08 Median $0.12 Typical High $0.17 | Facility | 53 · Discontinued | $0.08 | $0.12 | $0.17 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.06 Median $0.09 Typical High $0.13 | Facility | 55 · Aftercare only | $0.06 | $0.09 | $0.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.06 Typical High $0.08 | Facility | 56 · Pre-op care only | $0.04 | $0.06 | $0.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.20 Median $0.20 Typical High $0.22 | Professional | 52 · Reduced service | $0.20 | $0.20 | $0.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.09 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $0.60 Median $0.71 Typical High $0.81 | Facility | JZ · No drug discarded | $0.60 | $0.71 | $0.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 52 · Reduced service | $0.20 | $0.20 | $0.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.06 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Where Texas sits
The same service costs 1.9 times more in Alaska than in Rhode Island. 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· 7th of 51
$0.48
AK $0.74RI $0.39
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.