How much rates vary
Facilitymedian $30 · 10th to 90th $12 to $56Professionalmedian $12 · 10th to 90th $9 to $15
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 $10.00 Median $15.14 Typical High $20.89 | Facility | None | $10.00 | $15.14 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $9.12 Median $9.55 Typical High $13.18 | Professional | None | $9.12 | $9.55 | $13.18 |
BCBS Texas Setting Facility Modifier None Typical Low $12.88 Median $34.67 Typical High $57.54 | Facility | None | $12.88 | $34.67 | $57.54 |
BCBS Texas Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
Cigna Setting Facility Modifier None Typical Low $8.91 Median $13.49 Typical High $28.84 | Facility | None | $8.91 | $13.49 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | None | $8.91 | $8.91 | $8.91 |
Moda Health Setting Facility Modifier None Typical Low $9.55 Median $14.13 Typical High $19.95 | Facility | None | $9.55 | $14.13 | $19.95 |
Moda Health Setting Professional Modifier None Typical Low $9.12 Median $9.55 Typical High $12.02 | Professional | None | $9.12 | $9.55 | $12.02 |
Providence Setting Facility Modifier None Typical Low $8.91 Median $13.49 Typical High $75.86 | Facility | None | $8.91 | $13.49 | $75.86 |
Providence Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | None | $8.91 | $8.91 | $8.91 |
United Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | None | $15.49 | $15.49 | $15.49 |
Wellpoint Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
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 $5.01 Median $7.59 Typical High $10.47 | Facility | 52 · Reduced service | $5.01 | $7.59 | $10.47 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.00 Median $3.02 Typical High $4.17 | Facility | 53 · Discontinued | $2.00 | $3.02 | $4.17 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.48 Median $2.29 Typical High $3.16 | Facility | 55 · Aftercare only | $1.48 | $2.29 | $3.16 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.51 Typical High $2.09 | Facility | 56 · Pre-op care only | $1.00 | $1.51 | $2.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.57 Median $4.79 Typical High $6.61 | Professional | 52 · Reduced service | $4.57 | $4.79 | $6.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.82 Median $1.95 Typical High $2.63 | Professional | 53 · Discontinued | $1.82 | $1.95 | $2.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.38 Median $1.45 Typical High $1.95 | Professional | 55 · Aftercare only | $1.38 | $1.45 | $1.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.91 Median $0.98 Typical High $1.32 | Professional | 56 · Pre-op care only | $0.91 | $0.98 | $1.32 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $4.57 Median $4.79 Typical High $5.89 | Professional | 52 · Reduced service | $4.57 | $4.79 | $5.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.82 Median $1.95 Typical High $2.34 | Professional | 53 · Discontinued | $1.82 | $1.95 | $2.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.38 Median $1.45 Typical High $1.78 | Professional | 55 · Aftercare only | $1.38 | $1.45 | $1.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.91 Median $0.98 Typical High $1.17 | Professional | 56 · Pre-op care only | $0.91 | $0.98 | $1.17 |
Where Texas sits
The same service costs 2.6 times more in Alaska than in Ohio. 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
$15.85
AK $23.44OH $9.12
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.