How much rates vary
Facilitymedian $1 · 10th to 90th $0 to $1Professionalmedian $0 · 10th to 90th $0 to $0
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 $0.21 Median $0.32 Typical High $0.43 | Facility | None | $0.21 | $0.32 | $0.43 |
Aetna Setting Professional Modifier None Typical Low $0.20 Median $0.21 Typical High $0.24 | Professional | None | $0.20 | $0.21 | $0.24 |
BCBS Texas Setting Facility Modifier None Typical Low $0.21 Median $0.56 Typical High $1.07 | Facility | None | $0.21 | $0.56 | $1.07 |
BCBS Texas Setting Professional Modifier None Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | None | $0.21 | $0.21 | $0.21 |
Cigna Setting Facility Modifier None Typical Low $0.21 Median $0.32 Typical High $0.68 | Facility | None | $0.21 | $0.32 | $0.68 |
Cigna Setting Professional Modifier None Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | None | $0.21 | $0.21 | $0.21 |
Moda Health Setting Facility Modifier None Typical Low $0.21 Median $0.26 Typical High $0.48 | Facility | None | $0.21 | $0.26 | $0.48 |
Moda Health Setting Professional Modifier None Typical Low $0.20 Median $0.21 Typical High $0.21 | Professional | None | $0.20 | $0.21 | $0.21 |
Providence Setting Facility Modifier None Typical Low $0.21 Median $0.25 Typical High $1.82 | Facility | None | $0.21 | $0.25 | $1.82 |
Providence Setting Professional Modifier None Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | None | $0.21 | $0.21 | $0.21 |
United Setting Professional Modifier None Typical Low $0.25 Median $0.25 Typical High $0.25 | Professional | None | $0.25 | $0.25 | $0.25 |
Wellpoint Setting Professional Modifier None Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | None | $0.21 | $0.21 | $0.21 |
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 $0.11 Median $0.15 Typical High $0.22 | Facility | 52 · Reduced service | $0.11 | $0.15 | $0.22 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.04 Median $0.06 Typical High $0.09 | Facility | 53 · Discontinued | $0.04 | $0.06 | $0.09 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.03 Median $0.04 Typical High $0.06 | Facility | 55 · Aftercare only | $0.03 | $0.04 | $0.06 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.03 Typical High $0.04 | Facility | 56 · Pre-op care only | $0.02 | $0.03 | $0.04 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.10 Median $0.11 Typical High $0.12 | Professional | 52 · Reduced service | $0.10 | $0.11 | $0.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 53 · Discontinued | $0.04 | $0.04 | $0.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.10 Median $0.11 Typical High $0.11 | Professional | 52 · Reduced service | $0.10 | $0.11 | $0.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 53 · Discontinued | $0.04 | $0.04 | $0.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $0.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Where Texas sits
The same service costs 1.6 times more in Alaska than in Washington. 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
$0.30
AK $0.34WA $0.21
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.