How much rates vary
Facilitymedian $120 · 10th to 90th $21 to $1,413Professionalmedian $11 · 10th to 90th $11 to $12
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 $10.96 Median $16.98 Typical High $24.55 | Facility | None | $10.96 | $16.98 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $11.22 Typical High $14.79 | Professional | None | $10.96 | $11.22 | $14.79 |
BCBS Setting Facility Modifier None Typical Low $37.15 Median $95.50 Typical High $177.83 | Facility | None | $37.15 | $95.50 | $177.83 |
BCBS Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Christus Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $10.96 Median $25.70 Typical High $35.48 | Facility | None | $10.96 | $25.70 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
Moda Health Setting Facility Modifier None Typical Low $11.22 Median $14.79 Typical High $27.54 | Facility | None | $11.22 | $14.79 | $27.54 |
Moda Health Setting Professional Modifier None Typical Low $11.22 Median $11.48 Typical High $14.79 | Professional | None | $11.22 | $11.48 | $14.79 |
Molina Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
Providence Setting Facility Modifier None Typical Low $10.96 Median $15.85 Typical High $95.50 | Facility | None | $10.96 | $15.85 | $95.50 |
Providence Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
United Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
United Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
Wellpoint Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | None | $11.75 | $11.75 | $11.75 |
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 $5.50 Median $8.91 Typical High $12.30 | Facility | 52 · Reduced service | $5.50 | $8.91 | $12.30 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.19 Median $3.63 Typical High $4.90 | Facility | 53 · Discontinued | $2.19 | $3.63 | $4.90 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.66 Median $2.69 Typical High $3.72 | Facility | 55 · Aftercare only | $1.66 | $2.69 | $3.72 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.82 Typical High $2.45 | Facility | 56 · Pre-op care only | $1.10 | $1.82 | $2.45 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.50 Median $5.62 Typical High $6.03 | Professional | 52 · Reduced service | $5.50 | $5.62 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.24 Typical High $2.45 | Professional | 53 · Discontinued | $2.19 | $2.24 | $2.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.66 Typical High $1.82 | Professional | 55 · Aftercare only | $1.66 | $1.66 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.12 Typical High $1.20 | Professional | 56 · Pre-op care only | $1.10 | $1.12 | $1.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5.62 Median $5.75 Typical High $5.89 | Professional | 52 · Reduced service | $5.62 | $5.75 | $5.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.29 Typical High $2.34 | Professional | 53 · Discontinued | $2.24 | $2.29 | $2.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.70 Typical High $1.78 | Professional | 55 · Aftercare only | $1.70 | $1.70 | $1.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.15 Typical High $1.17 | Professional | 56 · Pre-op care only | $1.12 | $1.15 | $1.17 |
Where Texas sits
The same service costs 302.0 times more in Alabama 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· 2nd of 51
$57.54
AL $3,311GA $10.96
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.