How much rates vary
Facilitymedian $10 · 10th to 90th $4 to $19Professionalmedian $4 · 10th to 90th $4 to $10
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 $3.89 Median $15.85 Typical High $22.39 | Facility | None | $3.89 | $15.85 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $3.98 Typical High $4.37 | Professional | None | $3.89 | $3.98 | $4.37 |
BCBS Texas Setting Facility Modifier None Typical Low $3.80 Median $9.77 Typical High $19.05 | Facility | None | $3.80 | $9.77 | $19.05 |
BCBS Texas Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | None | $3.80 | $3.80 | $3.80 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $9.12 Typical High $12.88 | Facility | None | $3.89 | $9.12 | $12.88 |
Cigna Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
Moda Health Setting Facility Modifier None Typical Low $6.46 Median $13.18 Typical High $21.38 | Facility | None | $6.46 | $13.18 | $21.38 |
Moda Health Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.96 | Professional | None | $10.47 | $10.47 | $10.96 |
Molina Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Providence Setting Facility Modifier None Typical Low $3.89 Median $5.62 Typical High $33.11 | Facility | None | $3.89 | $5.62 | $33.11 |
Providence Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
United Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
Wellpoint Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
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 $1.95 Median $8.32 Typical High $11.22 | Facility | 52 · Reduced service | $1.95 | $8.32 | $11.22 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.78 Median $3.31 Typical High $4.57 | Facility | 53 · Discontinued | $0.78 | $3.31 | $4.57 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.59 Median $2.45 Typical High $3.39 | Facility | 55 · Aftercare only | $0.59 | $2.45 | $3.39 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.39 Median $1.66 Typical High $2.24 | Facility | 56 · Pre-op care only | $0.39 | $1.66 | $2.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.95 Median $2.00 Typical High $2.14 | Professional | 52 · Reduced service | $1.95 | $2.00 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.78 Median $0.79 Typical High $0.85 | Professional | 53 · Discontinued | $0.78 | $0.79 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.59 Median $0.59 Typical High $0.65 | Professional | 55 · Aftercare only | $0.59 | $0.59 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.40 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.39 | $0.40 | $0.43 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.25 Median $5.25 Typical High $5.37 | Professional | 52 · Reduced service | $5.25 | $5.25 | $5.37 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.09 Median $2.09 Typical High $2.14 | Professional | 53 · Discontinued | $2.09 | $2.09 | $2.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.55 Median $1.58 Typical High $1.62 | Professional | 55 · Aftercare only | $1.55 | $1.58 | $1.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.05 Typical High $1.07 | Professional | 56 · Pre-op care only | $1.05 | $1.05 | $1.07 |
Where Texas sits
The same service costs 3.2 times more in Hawaii than in Georgia. 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· 8th of 51
$9.55
HI $12.59GA $3.89
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.