How much rates vary
Facilitymedian $1 · 10th to 90th $0 to $2Professionalmedian $0 · 10th to 90th $0 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 $0.55 Median $0.65 Typical High $0.93 | Facility | None | $0.55 | $0.65 | $0.93 |
Aetna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.60 | Professional | None | $0.55 | $0.55 | $0.60 |
BCBS Texas Setting Facility Modifier None Typical Low $0.40 Median $0.89 Typical High $1.70 | Facility | None | $0.40 | $0.89 | $1.70 |
BCBS Texas Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | None | $0.48 | $0.48 | $0.48 |
Cigna Setting Facility Modifier None Typical Low $0.55 Median $1.02 Typical High $1.78 | Facility | None | $0.55 | $1.02 | $1.78 |
Cigna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Moda Health Setting Facility Modifier None Typical Low $0.42 Median $0.60 Typical High $1.48 | Facility | None | $0.42 | $0.60 | $1.48 |
Moda Health Setting Professional Modifier None Typical Low $0.42 Median $0.43 Typical High $0.46 | Professional | None | $0.42 | $0.43 | $0.46 |
Molina Setting Professional Modifier None Typical Low $0.43 Median $0.55 Typical High $0.60 | Professional | None | $0.43 | $0.55 | $0.60 |
Providence Setting Facility Modifier None Typical Low $0.55 Median $0.79 Typical High $4.68 | Facility | None | $0.55 | $0.79 | $4.68 |
Providence Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
United Setting Professional Modifier None Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | None | $0.42 | $0.42 | $0.42 |
Wellpoint Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | None | $0.60 | $0.60 | $0.60 |
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 $0.28 Median $0.32 Typical High $0.46 | Facility | 52 · Reduced service | $0.28 | $0.32 | $0.46 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.11 Median $0.13 Typical High $0.19 | Facility | 53 · Discontinued | $0.11 | $0.13 | $0.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.08 Median $0.10 Typical High $0.14 | Facility | 55 · Aftercare only | $0.08 | $0.10 | $0.14 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.09 | Facility | 56 · Pre-op care only | $0.06 | $0.06 | $0.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.28 Median $0.28 Typical High $0.30 | Professional | 52 · Reduced service | $0.28 | $0.28 | $0.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.11 Typical High $0.12 | Professional | 53 · Discontinued | $0.11 | $0.11 | $0.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $0.09 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.21 Median $0.22 Typical High $0.22 | Professional | 52 · Reduced service | $0.21 | $0.22 | $0.22 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.09 Typical High $0.09 | Professional | 53 · Discontinued | $0.08 | $0.09 | $0.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Where Texas sits
The same service costs 2.1 times more in Arizona than in Maryland. 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· 10th of 51
$0.62
AZ $0.87MD $0.42
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.