How much rates vary
Facilitymedian $3 · 10th to 90th $1 to $7Professionalmedian $1 · 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 $0.79 Median $0.95 Typical High $1.74 | Facility | None | $0.79 | $0.95 | $1.74 |
Aetna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $1.15 | Professional | None | $0.79 | $0.79 | $1.15 |
BCBS Texas Setting Facility Modifier None Typical Low $0.34 Median $0.85 Typical High $1.74 | Facility | None | $0.34 | $0.85 | $1.74 |
BCBS Texas Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $0.38 | Professional | None | $0.38 | $0.38 | $0.38 |
Baylor Scott & White Setting Facility Modifier None Typical Low $0.68 Median $0.85 Typical High $5.75 | Facility | None | $0.68 | $0.85 | $5.75 |
Christus Setting Facility Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Facility | None | $6.46 | $6.46 | $6.46 |
Cigna Setting Facility Modifier None Typical Low $0.79 Median $1.51 Typical High $2.51 | Facility | None | $0.79 | $1.51 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Health Smart Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.32 | Professional | None | $1.12 | $1.12 | $1.32 |
Lucent Health Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.32 | Professional | None | $1.12 | $1.12 | $1.32 |
Moda Health Setting Facility Modifier None Typical Low $1.29 Median $4.07 Typical High $8.51 | Facility | None | $1.29 | $4.07 | $8.51 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $1.78 Median $3.55 Typical High $7.94 | Facility | JZ · No drug discarded | $1.78 | $3.55 | $7.94 |
Moda Health Setting Professional Modifier None Typical Low $0.79 Median $0.85 Typical High $1.15 | Professional | None | $0.79 | $0.85 | $1.15 |
Molina Setting Professional Modifier None Typical Low $0.79 Median $0.83 Typical High $0.85 | Professional | None | $0.79 | $0.83 | $0.85 |
Providence Setting Facility Modifier None Typical Low $0.79 Median $1.12 Typical High $6.92 | Facility | None | $0.79 | $1.12 | $6.92 |
Providence Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
United Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | None | $0.85 | $0.85 | $0.85 |
Wellpoint Setting Professional Modifier None Typical Low $0.83 Median $0.83 Typical High $0.83 | Professional | None | $0.83 | $0.83 | $0.83 |
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 $0.40 Median $0.68 Typical High $0.91 | Facility | 52 · Reduced service | $0.40 | $0.68 | $0.91 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.16 Median $0.26 Typical High $0.37 | Facility | 53 · Discontinued | $0.16 | $0.26 | $0.37 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.12 Median $0.20 Typical High $0.28 | Facility | 55 · Aftercare only | $0.12 | $0.20 | $0.28 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.13 Typical High $0.18 | Facility | 56 · Pre-op care only | $0.08 | $0.13 | $0.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.40 Median $0.40 Typical High $0.44 | Professional | 52 · Reduced service | $0.40 | $0.40 | $0.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.16 Typical High $0.18 | Professional | 53 · Discontinued | $0.16 | $0.16 | $0.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.13 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.43 Median $0.43 Typical High $0.44 | Professional | 52 · Reduced service | $0.43 | $0.43 | $0.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.17 Median $0.17 Typical High $0.18 | Professional | 53 · Discontinued | $0.17 | $0.17 | $0.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 55 · Aftercare only | $0.13 | $0.13 | $0.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.09 |
Where Texas sits
The same service costs 2.3 times more in Alaska 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
$1.70
AK $1.82AL $0.79
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.