How much rates vary
Facilitymedian $4 · 10th to 90th $1 to $8Professionalmedian $1 · 10th to 90th $1 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 $1.10 Median $1.62 Typical High $2.24 | Facility | None | $1.10 | $1.62 | $2.24 |
Aetna Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.12 | Professional | None | $1.10 | $1.10 | $1.12 |
BCBS Texas Setting Facility Modifier None Typical Low $1.82 Median $4.79 Typical High $8.13 | Facility | None | $1.82 | $4.79 | $8.13 |
BCBS Texas Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | None | $1.45 | $1.45 | $1.45 |
Cigna Setting Facility Modifier None Typical Low $1.10 Median $2.04 Typical High $3.47 | Facility | None | $1.10 | $2.04 | $3.47 |
Cigna Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
Lucent Health Setting Professional Modifier None Typical Low $1.62 Median $1.78 Typical High $2.95 | Professional | None | $1.62 | $1.78 | $2.95 |
Moda Health Setting Facility Modifier None Typical Low $1.02 Median $1.45 Typical High $2.14 | Facility | None | $1.02 | $1.45 | $2.14 |
Moda Health Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.07 | Professional | None | $1.02 | $1.02 | $1.07 |
Moda Health Setting Professional Modifier JA · Given by IV Typical Low $5.25 Median $8.32 Typical High $10.00 | Professional | JA · Given by IV | $5.25 | $8.32 | $10.00 |
Molina Setting Professional Modifier None Typical Low $0.72 Median $0.76 Typical High $0.85 | Professional | None | $0.72 | $0.76 | $0.85 |
Oscar Health Setting Professional Modifier None Typical Low $1.12 Median $2.14 Typical High $3.80 | Professional | None | $1.12 | $2.14 | $3.80 |
Providence Setting Facility Modifier None Typical Low $1.10 Median $1.55 Typical High $9.33 | Facility | None | $1.10 | $1.55 | $9.33 |
Providence Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.07 | Professional | None | $1.02 | $1.02 | $1.07 |
Wellpoint Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | None | $1.23 | $1.23 | $1.23 |
15 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 $0.55 Median $0.81 Typical High $1.12 | Facility | 52 · Reduced service | $0.55 | $0.81 | $1.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.22 Median $0.33 Typical High $0.45 | Facility | 53 · Discontinued | $0.22 | $0.33 | $0.45 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.16 Median $0.25 Typical High $0.34 | Facility | 55 · Aftercare only | $0.16 | $0.25 | $0.34 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.16 Typical High $0.22 | Facility | 56 · Pre-op care only | $0.11 | $0.16 | $0.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.55 Median $0.55 Typical High $0.56 | Professional | 52 · Reduced service | $0.55 | $0.55 | $0.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.16 Typical High $0.17 | Professional | 55 · Aftercare only | $0.16 | $0.16 | $0.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 52 · Reduced service | $0.52 | $0.52 | $0.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 53 · Discontinued | $0.21 | $0.21 | $0.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.15 Typical High $0.16 | Professional | 55 · Aftercare only | $0.15 | $0.15 | $0.16 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.11 |
Moda Health Setting Professional Modifier EC · Anemia drug, other cause Typical Low $5.13 Median $8.51 Typical High $9.77 | Professional | EC · Anemia drug, other cause | $5.13 | $8.51 | $9.77 |
Moda Health Setting Professional Modifier JB · Given under the skin Typical Low $3.80 Median $6.03 Typical High $9.77 | Professional | JB · Given under the skin | $3.80 | $6.03 | $9.77 |
Moda Health Setting Professional Modifier JZ · No drug discarded Typical Low $8.13 Median $9.33 Typical High $11.48 | Professional | JZ · No drug discarded | $8.13 | $9.33 | $11.48 |
Where Texas sits
The same service costs 2.7 times more in Wyoming than in Alabama. 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· 48th of 51
$1.10
WY $2.95AL $1.10
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.