How much rates vary
Facilitymedian $25 · 10th to 90th $10 to $59Professionalmedian $7 · 10th to 90th $7 to $34
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 $6.76 Median $8.13 Typical High $15.85 | Facility | None | $6.76 | $8.13 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $7.59 | Professional | None | $6.76 | $6.76 | $7.59 |
BCBS Texas Setting Facility Modifier None Typical Low $33.88 Median $50.12 Typical High $66.07 | Facility | None | $33.88 | $50.12 | $66.07 |
BCBS Texas Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Christus Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $6.76 Median $15.85 Typical High $22.39 | Facility | None | $6.76 | $15.85 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Moda Health Setting Facility Modifier None Typical Low $7.24 Median $17.38 Typical High $57.54 | Facility | None | $7.24 | $17.38 | $57.54 |
Moda Health Setting Professional Modifier None Typical Low $6.76 Median $7.24 Typical High $7.94 | Professional | None | $6.76 | $7.24 | $7.94 |
Molina Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | None | $9.12 | $9.12 | $9.12 |
Providence Setting Facility Modifier None Typical Low $6.76 Median $9.77 Typical High $57.54 | Facility | None | $6.76 | $9.77 | $57.54 |
Providence Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
United Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
Wellpoint Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | None | $9.12 | $9.12 | $9.12 |
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 $3.39 Median $5.75 Typical High $7.94 | Facility | 52 · Reduced service | $3.39 | $5.75 | $7.94 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.35 Median $2.29 Typical High $3.16 | Facility | 53 · Discontinued | $1.35 | $2.29 | $3.16 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.00 Median $1.74 Typical High $2.34 | Facility | 55 · Aftercare only | $1.00 | $1.74 | $2.34 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.68 Median $1.15 Typical High $1.58 | Facility | 56 · Pre-op care only | $0.68 | $1.15 | $1.58 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.39 Median $3.39 Typical High $3.72 | Professional | 52 · Reduced service | $3.39 | $3.39 | $3.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.35 Median $1.35 Typical High $1.48 | Professional | 53 · Discontinued | $1.35 | $1.35 | $1.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.00 Median $1.02 Typical High $1.12 | Professional | 55 · Aftercare only | $1.00 | $1.02 | $1.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.68 Median $0.68 Typical High $0.74 | Professional | 56 · Pre-op care only | $0.68 | $0.68 | $0.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.63 Median $3.63 Typical High $3.80 | Professional | 52 · Reduced service | $3.63 | $3.63 | $3.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.45 Median $1.45 Typical High $1.51 | Professional | 53 · Discontinued | $1.45 | $1.45 | $1.51 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.10 Typical High $1.12 | Professional | 55 · Aftercare only | $1.07 | $1.10 | $1.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $0.72 Typical High $0.76 | Professional | 56 · Pre-op care only | $0.72 | $0.72 | $0.76 |
Where Texas sits
The same service costs 6.0 times more in Wyoming 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· 3rd of 51
$25.12
WY $40.74GA $6.76
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.