How much rates vary
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 $24.55 Median $25.70 Typical High $58.88 | Facility | None | $24.55 | $25.70 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $25.12 Typical High $25.70 | Professional | None | $24.55 | $25.12 | $25.70 |
BCBS Texas Setting Facility Modifier None Typical Low $25.12 Median $61.66 Typical High $114.82 | Facility | None | $25.12 | $61.66 | $114.82 |
BCBS Texas Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $47.86 Typical High $79.43 | Facility | None | $24.55 | $47.86 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Moda Health Setting Facility Modifier None Typical Low $23.99 Median $26.30 Typical High $58.88 | Facility | None | $23.99 | $26.30 | $58.88 |
Moda Health Setting Professional Modifier None Typical Low $23.99 Median $24.55 Typical High $26.30 | Professional | None | $23.99 | $24.55 | $26.30 |
Providence Setting Facility Modifier None Typical Low $24.55 Median $35.48 Typical High $208.93 | Facility | None | $24.55 | $35.48 | $208.93 |
Providence Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
United Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
United Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Wellpoint Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
8 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 Professional Modifier 52 · Reduced service Typical Low $12.30 Median $12.59 Typical High $12.59 | Professional | 52 · Reduced service | $12.30 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.01 Typical High $5.13 | Professional | 53 · Discontinued | $4.90 | $5.01 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.80 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.45 | $2.51 | $2.51 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.02 Median $12.30 Typical High $12.59 | Professional | 52 · Reduced service | $12.02 | $12.30 | $12.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.90 Typical High $5.01 | Professional | 53 · Discontinued | $4.79 | $4.90 | $5.01 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.63 Typical High $3.72 | Professional | 55 · Aftercare only | $3.63 | $3.63 | $3.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.45 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.40 | $2.45 | $2.51 |
Where Texas sits
The same service costs 1.6 times more in Alaska than in Mississippi. 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
$34.67
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.