How much rates vary
Facilitymedian $14 · 10th to 90th $7 to $30Professionalmedian $7 · 10th to 90th $6 to $10
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 $7.08 Median $9.77 Typical High $15.14 | Facility | None | $7.08 | $9.77 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $7.08 Median $7.24 Typical High $10.47 | Professional | None | $7.08 | $7.24 | $10.47 |
Ambetter Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $7.08 | Professional | None | $6.03 | $6.03 | $7.08 |
BCBS Texas Setting Facility Modifier None Typical Low $6.92 Median $15.49 Typical High $29.51 | Facility | None | $6.92 | $15.49 | $29.51 |
BCBS Texas Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Christus Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Facility | None | $6.76 | $6.76 | $6.76 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $13.49 Typical High $22.91 | Facility | None | $7.08 | $13.49 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Health Smart Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $12.02 | Professional | None | $10.23 | $10.23 | $12.02 |
Lucent Health Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $12.02 | Professional | None | $10.23 | $10.23 | $12.02 |
Moda Health Setting Facility Modifier None Typical Low $8.71 Median $18.20 Typical High $30.20 | Facility | None | $8.71 | $18.20 | $30.20 |
Moda Health Setting Professional Modifier None Typical Low $6.92 Median $7.24 Typical High $10.23 | Professional | None | $6.92 | $7.24 | $10.23 |
Molina Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
Providence Setting Facility Modifier None Typical Low $6.92 Median $8.51 Typical High $61.66 | Facility | None | $6.92 | $8.51 | $61.66 |
Providence Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
United Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
Wellpoint Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
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 $3.55 Median $5.62 Typical High $7.59 | Facility | 52 · Reduced service | $3.55 | $5.62 | $7.59 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.45 Median $2.24 Typical High $3.02 | Facility | 53 · Discontinued | $1.45 | $2.24 | $3.02 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.07 Median $1.66 Typical High $2.29 | Facility | 55 · Aftercare only | $1.07 | $1.66 | $2.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.71 Median $1.12 Typical High $1.51 | Facility | 56 · Pre-op care only | $0.71 | $1.12 | $1.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.55 Median $3.63 Typical High $3.89 | Professional | 52 · Reduced service | $3.55 | $3.63 | $3.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.45 Typical High $1.58 | Professional | 53 · Discontinued | $1.45 | $1.45 | $1.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.07 Typical High $1.17 | Professional | 55 · Aftercare only | $1.07 | $1.07 | $1.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.72 Typical High $0.78 | Professional | 56 · Pre-op care only | $0.71 | $0.72 | $0.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.47 Median $3.55 Typical High $3.63 | Professional | 52 · Reduced service | $3.47 | $3.55 | $3.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.38 Median $1.41 Typical High $1.45 | Professional | 53 · Discontinued | $1.38 | $1.41 | $1.45 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.05 Median $1.07 Typical High $1.10 | Professional | 55 · Aftercare only | $1.05 | $1.07 | $1.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.71 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.71 | $0.71 | $0.72 |
Where Texas sits
The same service costs 2.0 times more in Alaska than in Maryland. 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· 14th of 51
$8.13
AK $14.13MD $6.92
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.