How much rates vary
Facilitymedian $5 · 10th to 90th $1 to $9Professionalmedian $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 $0.62 Median $0.89 Typical High $1.41 | Facility | None | $0.62 | $0.89 | $1.41 |
Aetna Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $0.68 | Professional | None | $0.62 | $0.62 | $0.68 |
BCBS Texas Setting Facility Modifier None Typical Low $2.40 Median $6.03 Typical High $8.71 | Facility | None | $2.40 | $6.03 | $8.71 |
BCBS Texas Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | None | $1.45 | $1.45 | $1.45 |
Cigna Setting Facility Modifier None Typical Low $0.62 Median $1.15 Typical High $1.95 | Facility | None | $0.62 | $1.15 | $1.95 |
Cigna Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | None | $0.62 | $0.62 | $0.62 |
Moda Health Setting Facility Modifier None Typical Low $0.83 Median $2.95 Typical High $8.71 | Facility | None | $0.83 | $2.95 | $8.71 |
Moda Health Setting Professional Modifier None Typical Low $0.62 Median $0.65 Typical High $0.71 | Professional | None | $0.62 | $0.65 | $0.71 |
Molina Setting Professional Modifier None Typical Low $0.60 Median $0.62 Typical High $0.65 | Professional | None | $0.60 | $0.62 | $0.65 |
Providence Setting Facility Modifier None Typical Low $0.62 Median $0.89 Typical High $5.25 | Facility | None | $0.62 | $0.89 | $5.25 |
Providence Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | None | $0.62 | $0.62 | $0.62 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
Wellpoint Setting Professional Modifier None Typical Low $0.59 Median $0.59 Typical High $0.59 | Professional | None | $0.59 | $0.59 | $0.59 |
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 $0.31 Median $0.51 Typical High $0.71 | Facility | 52 · Reduced service | $0.31 | $0.51 | $0.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.12 Median $0.20 Typical High $0.28 | Facility | 53 · Discontinued | $0.12 | $0.20 | $0.28 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.09 Median $0.15 Typical High $0.21 | Facility | 55 · Aftercare only | $0.09 | $0.15 | $0.21 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.10 Typical High $0.14 | Facility | 56 · Pre-op care only | $0.06 | $0.10 | $0.14 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.31 Median $0.31 Typical High $0.34 | Professional | 52 · Reduced service | $0.31 | $0.31 | $0.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.12 Typical High $0.14 | Professional | 53 · Discontinued | $0.12 | $0.12 | $0.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.10 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.07 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $1.32 Median $3.98 Typical High $7.24 | Facility | JZ · No drug discarded | $1.32 | $3.98 | $7.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.32 Median $0.33 Typical High $0.34 | Professional | 52 · Reduced service | $0.32 | $0.33 | $0.34 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 53 · Discontinued | $0.13 | $0.13 | $0.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 55 · Aftercare only | $0.10 | $0.10 | $0.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.06 | $0.07 | $0.07 |
Where Texas sits
The same service costs 4.7 times more in Wyoming than in Georgia. 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
$1.91
WY $2.88GA $0.62
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.