How much rates vary
Facilitymedian $5 · 10th to 90th $2 to $9Professionalmedian $1 · 10th to 90th $1 to $2
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 $1.29 Median $1.66 Typical High $2.75 | Facility | None | $1.29 | $1.66 | $2.75 |
Aetna Setting Professional Modifier None Typical Low $1.29 Median $1.32 Typical High $1.45 | Professional | None | $1.29 | $1.32 | $1.45 |
BCBS Texas Setting Facility Modifier None Typical Low $2.00 Median $4.68 Typical High $8.51 | Facility | None | $2.00 | $4.68 | $8.51 |
BCBS Texas Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | None | $1.62 | $1.62 | $1.62 |
Cigna Setting Facility Modifier None Typical Low $1.29 Median $2.69 Typical High $4.17 | Facility | None | $1.29 | $2.69 | $4.17 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Moda Health Setting Facility Modifier None Typical Low $1.82 Median $5.75 Typical High $9.33 | Facility | None | $1.82 | $5.75 | $9.33 |
Moda Health Setting Professional Modifier None Typical Low $1.26 Median $1.29 Typical High $1.38 | Professional | None | $1.26 | $1.29 | $1.38 |
Molina Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | None | $1.23 | $1.23 | $1.23 |
Providence Setting Facility Modifier None Typical Low $1.29 Median $1.86 Typical High $11.22 | Facility | None | $1.29 | $1.86 | $11.22 |
Providence Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
United Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Wellpoint Setting Professional Modifier None Typical Low $0.87 Median $0.87 Typical High $0.87 | Professional | None | $0.87 | $0.87 | $0.87 |
13 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 $0.65 Median $1.00 Typical High $1.38 | Facility | 52 · Reduced service | $0.65 | $1.00 | $1.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.26 Median $0.40 Typical High $0.55 | Facility | 53 · Discontinued | $0.26 | $0.40 | $0.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.20 Median $0.28 Typical High $0.41 | Facility | 55 · Aftercare only | $0.20 | $0.28 | $0.41 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.20 Typical High $0.28 | Facility | 56 · Pre-op care only | $0.13 | $0.20 | $0.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.65 Median $0.66 Typical High $0.72 | Professional | 52 · Reduced service | $0.65 | $0.66 | $0.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.26 Typical High $0.28 | Professional | 53 · Discontinued | $0.26 | $0.26 | $0.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $0.21 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.14 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $3.24 Median $5.89 Typical High $9.55 | Facility | JZ · No drug discarded | $3.24 | $5.89 | $9.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.65 Median $0.65 Typical High $0.66 | Professional | 52 · Reduced service | $0.65 | $0.65 | $0.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.25 Median $0.26 Typical High $0.26 | Professional | 53 · Discontinued | $0.25 | $0.26 | $0.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.19 Typical High $0.20 | Professional | 55 · Aftercare only | $0.19 | $0.19 | $0.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.13 |
Where Texas sits
The same service costs 2.5 times more in Texas than in Nebraska. 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· 1st of 51
$3.16
TX $3.16NE $1.26
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.