How much rates vary
Facilitymedian $3 · 10th to 90th $1 to $5Professionalmedian $0 · 10th to 90th $0 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 $0.68 Median $1.05 Typical High $1.45 | Facility | None | $0.68 | $1.05 | $1.45 |
Aetna Setting Professional Modifier None Typical Low $0.66 Median $0.68 Typical High $0.68 | Professional | None | $0.66 | $0.68 | $0.68 |
BCBS Texas Setting Facility Modifier None Typical Low $1.20 Median $2.95 Typical High $5.37 | Facility | None | $1.20 | $2.95 | $5.37 |
BCBS Texas Setting Professional Modifier None Typical Low $1.10 Median $1.12 Typical High $1.12 | Professional | None | $1.10 | $1.12 | $1.12 |
Cigna Setting Facility Modifier None Typical Low $0.27 Median $0.63 Typical High $0.85 | Facility | None | $0.27 | $0.63 | $0.85 |
Cigna Setting Professional Modifier None Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | None | $0.27 | $0.27 | $0.27 |
Moda Health Setting Facility Modifier None Typical Low $0.46 Median $0.87 Typical High $1.58 | Facility | None | $0.46 | $0.87 | $1.58 |
Moda Health Setting Professional Modifier None Typical Low $0.66 Median $0.68 Typical High $0.68 | Professional | None | $0.66 | $0.68 | $0.68 |
Providence Setting Facility Modifier None Typical Low $0.27 Median $0.68 Typical High $2.29 | Facility | None | $0.27 | $0.68 | $2.29 |
Providence Setting Professional Modifier None Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | None | $0.27 | $0.27 | $0.27 |
United Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $0.38 | Professional | None | $0.38 | $0.38 | $0.38 |
Wellpoint Setting Professional Modifier None Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | None | $0.27 | $0.27 | $0.27 |
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 $0.34 Median $0.52 Typical High $0.71 | Facility | 52 · Reduced service | $0.34 | $0.52 | $0.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.13 Median $0.21 Typical High $0.28 | Facility | 53 · Discontinued | $0.13 | $0.21 | $0.28 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.10 Median $0.15 Typical High $0.21 | Facility | 55 · Aftercare only | $0.10 | $0.15 | $0.21 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.10 Typical High $0.14 | Facility | 56 · Pre-op care only | $0.07 | $0.10 | $0.14 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.33 Median $0.34 Typical High $0.34 | Professional | 52 · Reduced service | $0.33 | $0.34 | $0.34 |
Aetna 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 |
Aetna 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 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.07 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.33 Median $0.34 Typical High $0.34 | Professional | 52 · Reduced service | $0.33 | $0.34 | $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 $0.07 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.07 |
Where Texas sits
The same service costs 6.3 times more in Kansas than in Virginia. 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· 3rd of 51
$1.23
KS $1.78VA $0.28
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.