How much rates vary
Facilitymedian $2 · 10th to 90th $0 to $5Professionalmedian $0 · 10th to 90th $0 to $0
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 $0.20 Median $0.24 Typical High $0.35 | Facility | None | $0.20 | $0.24 | $0.35 |
Aetna Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.21 | Professional | None | $0.20 | $0.20 | $0.21 |
BCBS Texas Setting Facility Modifier None Typical Low $0.72 Median $1.58 Typical High $2.95 | Facility | None | $0.72 | $1.58 | $2.95 |
BCBS Texas Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
Baylor Scott & White Setting Professional Modifier None Typical Low $0.16 Median $0.16 Typical High $0.28 | Professional | None | $0.16 | $0.16 | $0.28 |
Christus Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Facility | None | $4.68 | $4.68 | $4.68 |
Cigna Setting Facility Modifier None Typical Low $0.20 Median $0.38 Typical High $0.65 | Facility | None | $0.20 | $0.38 | $0.65 |
Cigna Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | None | $0.20 | $0.20 | $0.20 |
Lucent Health Setting Professional Modifier None Typical Low $0.26 Median $0.33 Typical High $0.91 | Professional | None | $0.26 | $0.33 | $0.91 |
Moda Health Setting Facility Modifier None Typical Low $0.16 Median $0.78 Typical High $3.89 | Facility | None | $0.16 | $0.78 | $3.89 |
Moda Health Setting Professional Modifier None Typical Low $0.16 Median $0.17 Typical High $0.20 | Professional | None | $0.16 | $0.17 | $0.20 |
Molina Setting Professional Modifier None Typical Low $0.15 Median $0.17 Typical High $0.20 | Professional | None | $0.15 | $0.17 | $0.20 |
Oscar Health Setting Professional Modifier None Typical Low $0.16 Median $0.28 Typical High $0.60 | Professional | None | $0.16 | $0.28 | $0.60 |
Providence Setting Facility Modifier None Typical Low $0.20 Median $0.29 Typical High $1.70 | Facility | None | $0.20 | $0.29 | $1.70 |
Providence Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | None | $0.20 | $0.20 | $0.20 |
United Setting Professional Modifier None Typical Low $0.16 Median $0.17 Typical High $4.07 | Professional | None | $0.16 | $0.17 | $4.07 |
Wellpoint Setting Professional Modifier None Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | None | $0.15 | $0.15 | $0.15 |
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 $0.10 Median $0.12 Typical High $0.17 | Facility | 52 · Reduced service | $0.10 | $0.12 | $0.17 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.04 Median $0.05 Typical High $0.07 | Facility | 53 · Discontinued | $0.04 | $0.05 | $0.07 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $0.05 | Facility | 55 · Aftercare only | $0.03 | $0.03 | $0.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.03 | Facility | 56 · Pre-op care only | $0.02 | $0.02 | $0.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 52 · Reduced service | $0.10 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 53 · Discontinued | $0.04 | $0.04 | $0.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.08 Median $0.08 Typical High $0.09 | Professional | 52 · Reduced service | $0.08 | $0.08 | $0.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 53 · Discontinued | $0.03 | $0.03 | $0.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.03 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Where Texas sits
The same service costs 3.8 times more in Wyoming than in Michigan. 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· 47th of 51
$0.20
WY $0.76MI $0.20
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.