How much rates vary
Facilitymedian $6 · 10th to 90th $3 to $11Professionalmedian $3 · 10th to 90th $3 to $3
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 $2.69 Median $4.17 Typical High $5.62 | Facility | None | $2.69 | $4.17 | $5.62 |
Aetna Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.95 | Professional | None | $2.69 | $2.69 | $2.95 |
BCBS Texas Setting Facility Modifier None Typical Low $2.29 Median $5.75 Typical High $10.72 | Facility | None | $2.29 | $5.75 | $10.72 |
BCBS Texas Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.55 | Professional | None | $2.57 | $2.57 | $3.55 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $5.13 Typical High $8.51 | Facility | None | $2.69 | $5.13 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
Moda Health Setting Facility Modifier None Typical Low $2.57 Median $3.39 Typical High $6.31 | Facility | None | $2.57 | $3.39 | $6.31 |
Moda Health Setting Professional Modifier None Typical Low $2.57 Median $2.63 Typical High $2.88 | Professional | None | $2.57 | $2.63 | $2.88 |
Molina Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | None | $2.63 | $2.63 | $2.63 |
Providence Setting Facility Modifier None Typical Low $2.69 Median $3.89 Typical High $22.91 | Facility | None | $2.69 | $3.89 | $22.91 |
Providence Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
United Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Wellpoint Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
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 $1.35 Median $2.04 Typical High $2.82 | Facility | 52 · Reduced service | $1.35 | $2.04 | $2.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.54 Median $0.83 Typical High $1.12 | Facility | 53 · Discontinued | $0.54 | $0.83 | $1.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.40 Median $0.62 Typical High $0.85 | Facility | 55 · Aftercare only | $0.40 | $0.62 | $0.85 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.41 Typical High $0.56 | Facility | 56 · Pre-op care only | $0.27 | $0.41 | $0.56 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.35 Median $1.35 Typical High $1.48 | Professional | 52 · Reduced service | $1.35 | $1.35 | $1.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.54 Median $0.54 Typical High $0.59 | Professional | 53 · Discontinued | $0.54 | $0.54 | $0.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.40 Median $0.41 Typical High $0.44 | Professional | 55 · Aftercare only | $0.40 | $0.41 | $0.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.27 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.27 | $0.27 | $0.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.29 Median $1.32 Typical High $1.35 | Professional | 52 · Reduced service | $1.29 | $1.32 | $1.35 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $0.52 Typical High $0.54 | Professional | 53 · Discontinued | $0.52 | $0.52 | $0.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.39 Median $0.39 Typical High $0.41 | Professional | 55 · Aftercare only | $0.39 | $0.39 | $0.41 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.26 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.26 | $0.26 | $0.27 |
Where Texas sits
The same service costs 1.7 times more in Arizona than in Rhode Island. 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· 3rd of 51
$3.89
AZ $4.37RI $2.57
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.