How much rates vary
Facilitymedian $3 · 10th to 90th $1 to $8Professionalmedian $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 $0.40 Median $0.41 Typical High $0.79 | Facility | None | $0.40 | $0.41 | $0.79 |
Aetna Setting Professional Modifier None Typical Low $0.40 Median $0.41 Typical High $0.56 | Professional | None | $0.40 | $0.41 | $0.56 |
BCBS Texas Setting Facility Modifier None Typical Low $2.51 Median $5.75 Typical High $8.91 | Facility | None | $2.51 | $5.75 | $8.91 |
BCBS Texas Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | None | $0.26 | $0.26 | $0.26 |
Baylor Scott & White Setting Professional Modifier None Typical Low $0.40 Median $0.47 Typical High $0.50 | Professional | None | $0.40 | $0.47 | $0.50 |
Christus Setting Facility Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Facility | None | $1.58 | $1.58 | $1.58 |
Cigna Setting Facility Modifier None Typical Low $0.40 Median $0.76 Typical High $1.29 | Facility | None | $0.40 | $0.76 | $1.29 |
Cigna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
Health Smart Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $4.27 | Professional | None | $3.63 | $3.63 | $4.27 |
Lucent Health Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $4.27 | Professional | None | $3.63 | $3.63 | $4.27 |
Moda Health Setting Facility Modifier None Typical Low $0.79 Median $2.69 Typical High $7.76 | Facility | None | $0.79 | $2.69 | $7.76 |
Moda Health Setting Professional Modifier None Typical Low $0.40 Median $0.43 Typical High $0.66 | Professional | None | $0.40 | $0.43 | $0.66 |
Molina Setting Professional Modifier None Typical Low $0.41 Median $0.43 Typical High $0.47 | Professional | None | $0.41 | $0.43 | $0.47 |
Providence Setting Facility Modifier None Typical Low $0.40 Median $0.59 Typical High $3.39 | Facility | None | $0.40 | $0.59 | $3.39 |
Providence Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
United Setting Professional Modifier None Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | None | $0.43 | $0.43 | $0.43 |
Wellpoint Setting Professional Modifier None Typical Low $0.46 Median $0.46 Typical High $0.46 | Professional | None | $0.46 | $0.46 | $0.46 |
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 $0.20 Median $0.32 Typical High $0.46 | Facility | 52 · Reduced service | $0.20 | $0.32 | $0.46 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.08 Median $0.13 Typical High $0.19 | Facility | 53 · Discontinued | $0.08 | $0.13 | $0.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.06 Median $0.10 Typical High $0.14 | Facility | 55 · Aftercare only | $0.06 | $0.10 | $0.14 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.06 Typical High $0.09 | Facility | 56 · Pre-op care only | $0.04 | $0.06 | $0.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.20 Median $0.21 Typical High $0.22 | Professional | 52 · Reduced service | $0.20 | $0.21 | $0.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.09 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $0.85 Median $2.63 Typical High $8.71 | Facility | JZ · No drug discarded | $0.85 | $2.63 | $8.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.22 Median $0.22 Typical High $0.23 | Professional | 52 · Reduced service | $0.22 | $0.22 | $0.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 53 · Discontinued | $0.09 | $0.09 | $0.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.05 |
Where Texas sits
The same service costs 4.0 times more in Texas than in Georgia. 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
$1.58
TX $1.58GA $0.40
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.