How much rates vary
Facilitymedian $98 · 10th to 90th $42 to $186Professionalmedian $34 · 10th to 90th $32 to $42
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 $31.62 Median $51.29 Typical High $74.13 | Facility | None | $31.62 | $51.29 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $34.67 | Professional | None | $31.62 | $31.62 | $34.67 |
BCBS Texas Setting Facility Modifier None Typical Low $41.69 Median $112.20 Typical High $199.53 | Facility | None | $41.69 | $112.20 | $199.53 |
BCBS Texas Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $61.66 Typical High $100.00 | Facility | None | $31.62 | $61.66 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Moda Health Setting Facility Modifier None Typical Low $33.88 Median $47.86 Typical High $70.79 | Facility | None | $33.88 | $47.86 | $70.79 |
Moda Health Setting Professional Modifier None Typical Low $33.88 Median $34.67 Typical High $35.48 | Professional | None | $33.88 | $34.67 | $35.48 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Providence Setting Facility Modifier None Typical Low $31.62 Median $45.71 Typical High $269.15 | Facility | None | $31.62 | $45.71 | $269.15 |
Providence Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
United Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Wellpoint Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
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 $15.85 Median $26.92 Typical High $37.15 | Facility | 52 · Reduced service | $15.85 | $26.92 | $37.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.31 Median $10.96 Typical High $14.79 | Facility | 53 · Discontinued | $6.31 | $10.96 | $14.79 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.68 Median $8.13 Typical High $11.22 | Facility | 55 · Aftercare only | $4.68 | $8.13 | $11.22 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.16 Median $5.37 Typical High $7.41 | Facility | 56 · Pre-op care only | $3.16 | $5.37 | $7.41 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $15.85 Typical High $17.38 | Professional | 52 · Reduced service | $15.85 | $15.85 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $6.92 | Professional | 53 · Discontinued | $6.31 | $6.31 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.79 Typical High $5.25 | Professional | 55 · Aftercare only | $4.68 | $4.79 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $17.38 Typical High $17.78 | Professional | 52 · Reduced service | $16.98 | $17.38 | $17.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.92 Typical High $7.08 | Professional | 53 · Discontinued | $6.76 | $6.92 | $7.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $5.37 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $5.37 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.47 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.39 | $3.47 | $3.55 |
Where Texas sits
The same service costs 2.3 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· 4th of 51
$54.95
WY $74.13GA $31.62
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.