How much rates vary
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 $5.50 Median $6.03 Typical High $13.18 | Facility | None | $5.50 | $6.03 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.62 | Professional | None | $5.50 | $5.50 | $5.62 |
BCBS Texas Setting Facility Modifier None Typical Low $6.03 Median $14.79 Typical High $28.18 | Facility | None | $6.03 | $14.79 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $10.72 Typical High $17.38 | Facility | None | $5.50 | $10.72 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Moda Health Setting Facility Modifier None Typical Low $5.50 Median $6.03 Typical High $13.18 | Facility | None | $5.50 | $6.03 | $13.18 |
Moda Health Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.75 | Professional | None | $5.50 | $5.50 | $5.75 |
Providence Setting Facility Modifier None Typical Low $5.50 Median $7.76 Typical High $46.77 | Facility | None | $5.50 | $7.76 | $46.77 |
Providence Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
United Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
United Setting Professional Modifier None Typical Low $5.50 Median $5.89 Typical High $6.17 | Professional | None | $5.50 | $5.89 | $6.17 |
Wellpoint Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | None | $5.37 | $5.37 | $5.37 |
8 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 Professional Modifier 52 · Reduced service Typical Low $2.75 Median $2.75 Typical High $2.82 | Professional | 52 · Reduced service | $2.75 | $2.75 | $2.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.10 Typical High $1.12 | Professional | 53 · Discontinued | $1.10 | $1.10 | $1.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $0.83 Typical High $0.83 | Professional | 55 · Aftercare only | $0.81 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.55 Typical High $0.56 | Professional | 56 · Pre-op care only | $0.55 | $0.55 | $0.56 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.75 Median $2.75 Typical High $2.82 | Professional | 52 · Reduced service | $2.75 | $2.75 | $2.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.12 Typical High $1.12 | Professional | 53 · Discontinued | $1.10 | $1.12 | $1.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $0.83 Typical High $0.85 | Professional | 55 · Aftercare only | $0.81 | $0.83 | $0.85 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.55 Typical High $0.58 | Professional | 56 · Pre-op care only | $0.55 | $0.55 | $0.58 |
Where Texas sits
The same service costs 1.9 times more in Alaska than in New Mexico. 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
$9.33
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.