How much rates vary
Facilitymedian $42 · 10th to 90th $12 to $98Professionalmedian $9 · 10th to 90th $9 to $27
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 $8.51 Median $10.23 Typical High $19.50 | Facility | None | $8.51 | $10.23 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $8.51 Median $8.71 Typical High $9.33 | Professional | None | $8.51 | $8.71 | $9.33 |
BCBS Texas Setting Facility Modifier None Typical Low $29.51 Median $67.61 Typical High $102.33 | Facility | None | $29.51 | $67.61 | $102.33 |
BCBS Texas Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Christus Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $8.51 Median $19.95 Typical High $28.18 | Facility | None | $8.51 | $19.95 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Moda Health Setting Facility Modifier None Typical Low $7.08 Median $56.23 Typical High $112.20 | Facility | None | $7.08 | $56.23 | $112.20 |
Moda Health Setting Professional Modifier None Typical Low $8.51 Median $9.55 Typical High $10.23 | Professional | None | $8.51 | $9.55 | $10.23 |
Molina Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | None | $11.75 | $11.75 | $11.75 |
Providence Setting Facility Modifier None Typical Low $8.51 Median $12.30 Typical High $72.44 | Facility | None | $8.51 | $12.30 | $72.44 |
Providence Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
United Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Wellpoint Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
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 $4.27 Median $7.41 Typical High $10.23 | Facility | 52 · Reduced service | $4.27 | $7.41 | $10.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.70 Median $3.02 Typical High $4.07 | Facility | 53 · Discontinued | $1.70 | $3.02 | $4.07 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.29 Median $2.24 Typical High $3.09 | Facility | 55 · Aftercare only | $1.29 | $2.24 | $3.09 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.85 Median $1.48 Typical High $2.04 | Facility | 56 · Pre-op care only | $0.85 | $1.48 | $2.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.27 Median $4.27 Typical High $4.68 | Professional | 52 · Reduced service | $4.27 | $4.27 | $4.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.74 Typical High $1.86 | Professional | 53 · Discontinued | $1.70 | $1.74 | $1.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $1.41 | Professional | 55 · Aftercare only | $1.29 | $1.29 | $1.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.85 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.85 | $0.85 | $0.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $4.68 Median $4.68 Typical High $4.90 | Professional | 52 · Reduced service | $4.68 | $4.68 | $4.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.86 Median $1.91 Typical High $1.95 | Professional | 53 · Discontinued | $1.86 | $1.91 | $1.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.41 Median $1.41 Typical High $1.45 | Professional | 55 · Aftercare only | $1.41 | $1.41 | $1.45 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.93 Median $0.95 Typical High $0.98 | Professional | 56 · Pre-op care only | $0.93 | $0.95 | $0.98 |
Where Texas sits
The same service costs 6.5 times more in Oklahoma than in Alabama. 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
$41.69
OK $54.95AL $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.