How much rates vary
Facilitymedian $9 · 10th to 90th $4 to $16Professionalmedian $4 · 10th to 90th $4 to $4
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 $4.27 Median $4.27 Typical High $10.00 | Facility | None | $4.27 | $4.27 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $4.27 Typical High $4.27 | Professional | None | $4.17 | $4.27 | $4.27 |
BCBS Texas Setting Facility Modifier None Typical Low $3.63 Median $8.71 Typical High $16.60 | Facility | None | $3.63 | $8.71 | $16.60 |
BCBS Texas Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Cigna Setting Facility Modifier None Typical Low $4.47 Median $6.61 Typical High $14.13 | Facility | None | $4.47 | $6.61 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Moda Health Setting Facility Modifier None Typical Low $4.17 Median $5.25 Typical High $10.00 | Facility | None | $4.17 | $5.25 | $10.00 |
Moda Health Setting Professional Modifier None Typical Low $4.17 Median $4.27 Typical High $4.27 | Professional | None | $4.17 | $4.27 | $4.27 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $4.17 Median $5.25 Typical High $38.02 | Facility | None | $4.17 | $5.25 | $38.02 |
Providence Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
United Setting Facility Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Facility | None | $2.45 | $2.45 | $2.45 |
United Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
Wellpoint Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | None | $4.17 | $4.17 | $4.17 |
8 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 Professional Modifier 52 · Reduced service Typical Low $2.09 Median $2.14 Typical High $2.14 | Professional | 52 · Reduced service | $2.09 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $0.85 Typical High $0.85 | Professional | 53 · Discontinued | $0.83 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.62 Median $0.65 Typical High $0.65 | Professional | 55 · Aftercare only | $0.62 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.43 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.42 | $0.43 | $0.43 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.09 Median $2.14 Typical High $2.14 | Professional | 52 · Reduced service | $2.09 | $2.14 | $2.14 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $0.85 Typical High $0.85 | Professional | 53 · Discontinued | $0.83 | $0.85 | $0.85 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.62 Median $0.65 Typical High $0.65 | Professional | 55 · Aftercare only | $0.62 | $0.65 | $0.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.43 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.42 | $0.43 | $0.43 |
Where Texas sits
The same service costs 1.8 times more in Alaska than in Kentucky. 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· 4th of 51
$5.13
AK $7.08KY $3.89
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.