How much rates vary
Facilitymedian $39 · 10th to 90th $16 to $81Professionalmedian $14 · 10th to 90th $14 to $19
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 $14.45 Median $22.91 Typical High $30.90 | Facility | None | $14.45 | $22.91 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $14.79 Typical High $15.85 | Professional | None | $14.45 | $14.79 | $15.85 |
BCBS Texas Setting Facility Modifier None Typical Low $19.50 Median $43.65 Typical High $81.28 | Facility | None | $19.50 | $43.65 | $81.28 |
BCBS Texas Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $27.54 Typical High $46.77 | Facility | None | $14.45 | $27.54 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Moda Health Setting Facility Modifier None Typical Low $14.13 Median $19.95 Typical High $33.88 | Facility | None | $14.13 | $19.95 | $33.88 |
Moda Health Setting Professional Modifier None Typical Low $14.13 Median $14.45 Typical High $15.85 | Professional | None | $14.13 | $14.45 | $15.85 |
Molina Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Providence Setting Facility Modifier None Typical Low $14.45 Median $20.42 Typical High $123.03 | Facility | None | $14.45 | $20.42 | $123.03 |
Providence Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
United Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Wellpoint Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
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 $7.24 Median $11.48 Typical High $15.49 | Facility | 52 · Reduced service | $7.24 | $11.48 | $15.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.88 Median $4.57 Typical High $6.17 | Facility | 53 · Discontinued | $2.88 | $4.57 | $6.17 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.19 Median $3.39 Typical High $4.68 | Facility | 55 · Aftercare only | $2.19 | $3.39 | $4.68 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.45 Median $2.29 Typical High $3.09 | Facility | 56 · Pre-op care only | $1.45 | $2.29 | $3.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.24 Median $7.24 Typical High $7.94 | Professional | 52 · Reduced service | $7.24 | $7.24 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $2.95 Typical High $3.16 | Professional | 53 · Discontinued | $2.88 | $2.95 | $3.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $2.19 Typical High $2.40 | Professional | 55 · Aftercare only | $2.19 | $2.19 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $1.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.08 Median $7.24 Typical High $7.41 | Professional | 52 · Reduced service | $7.08 | $7.24 | $7.41 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.88 Typical High $2.95 | Professional | 53 · Discontinued | $2.82 | $2.88 | $2.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.14 Typical High $2.24 | Professional | 55 · Aftercare only | $2.14 | $2.14 | $2.24 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $1.48 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $1.48 |
Where Texas sits
The same service costs 2.0 times more in Wyoming than in Oklahoma. 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· 4th of 51
$23.99
WY $28.84OK $14.13
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.