How much rates vary
Facilitymedian $63 · 10th to 90th $28 to $126Professionalmedian $26 · 10th to 90th $25 to $28
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 $28.18 Median $37.15 Typical High $53.70 | Facility | None | $28.18 | $37.15 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $30.90 | Professional | None | $28.18 | $28.18 | $30.90 |
BCBS Texas Setting Facility Modifier None Typical Low $28.84 Median $67.61 Typical High $128.82 | Facility | None | $28.84 | $67.61 | $128.82 |
BCBS Texas Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $52.48 Typical High $89.13 | Facility | None | $28.18 | $52.48 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Moda Health Setting Facility Modifier None Typical Low $21.88 Median $50.12 Typical High $120.23 | Facility | None | $21.88 | $50.12 | $120.23 |
Moda Health Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $26.92 | Professional | None | $24.55 | $24.55 | $26.92 |
Molina Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Providence Setting Facility Modifier None Typical Low $24.55 Median $33.88 Typical High $239.88 | Facility | None | $24.55 | $33.88 | $239.88 |
Providence Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
United Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Wellpoint Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
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 $14.13 Median $19.50 Typical High $26.30 | Facility | 52 · Reduced service | $14.13 | $19.50 | $26.30 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.62 Median $7.76 Typical High $10.72 | Facility | 53 · Discontinued | $5.62 | $7.76 | $10.72 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.27 Median $5.89 Typical High $7.94 | Facility | 55 · Aftercare only | $4.27 | $5.89 | $7.94 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.89 Typical High $5.37 | Facility | 56 · Pre-op care only | $2.82 | $3.89 | $5.37 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $14.13 Typical High $15.49 | Professional | 52 · Reduced service | $14.13 | $14.13 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $6.17 | Professional | 53 · Discontinued | $5.62 | $5.62 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $4.68 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $3.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $12.30 Typical High $12.59 | Professional | 52 · Reduced service | $12.30 | $12.30 | $12.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $5.13 | Professional | 53 · Discontinued | $4.90 | $4.90 | $5.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.72 Typical High $3.80 | Professional | 55 · Aftercare only | $3.63 | $3.72 | $3.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.51 |
Where Texas sits
The same service costs 2.2 times more in Alaska 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· 2nd of 51
$44.67
AK $48.98OK $22.39
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.