How much rates vary
Facilitymedian $4 · 10th to 90th $1 to $8Professionalmedian $1 · 10th to 90th $1 to $1
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 $0.54 Median $0.55 Typical High $1.12 | Facility | None | $0.54 | $0.55 | $1.12 |
Aetna Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.59 | Professional | None | $0.54 | $0.54 | $0.59 |
BCBS Texas Setting Facility Modifier None Typical Low $0.58 Median $2.95 Typical High $5.37 | Facility | None | $0.58 | $2.95 | $5.37 |
BCBS Texas Setting Professional Modifier None Typical Low $0.74 Median $0.74 Typical High $0.74 | Professional | None | $0.74 | $0.74 | $0.74 |
Cigna Setting Facility Modifier None Typical Low $0.54 Median $1.02 Typical High $1.74 | Facility | None | $0.54 | $1.02 | $1.74 |
Cigna Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | None | $0.54 | $0.54 | $0.54 |
Moda Health Setting Facility Modifier None Typical Low $1.00 Median $5.50 Typical High $7.94 | Facility | None | $1.00 | $5.50 | $7.94 |
Moda Health Setting Professional Modifier None Typical Low $0.54 Median $0.55 Typical High $0.63 | Professional | None | $0.54 | $0.55 | $0.63 |
Molina Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.55 | Professional | None | $0.54 | $0.54 | $0.55 |
Providence Setting Facility Modifier None Typical Low $0.54 Median $0.78 Typical High $4.57 | Facility | None | $0.54 | $0.78 | $4.57 |
Providence Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | None | $0.54 | $0.54 | $0.54 |
United Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | None | $0.54 | $0.54 | $0.54 |
Wellpoint Setting Professional Modifier None Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | None | $0.52 | $0.52 | $0.52 |
13 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 $0.27 Median $0.43 Typical High $0.59 | Facility | 52 · Reduced service | $0.27 | $0.43 | $0.59 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.11 Median $0.17 Typical High $0.24 | Facility | 53 · Discontinued | $0.11 | $0.17 | $0.24 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.08 Median $0.12 Typical High $0.18 | Facility | 55 · Aftercare only | $0.08 | $0.12 | $0.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.08 Typical High $0.12 | Facility | 56 · Pre-op care only | $0.05 | $0.08 | $0.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.27 Median $0.27 Typical High $0.30 | Professional | 52 · Reduced service | $0.27 | $0.27 | $0.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.11 Typical High $0.12 | Professional | 53 · Discontinued | $0.11 | $0.11 | $0.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $0.09 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.06 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $1.02 Median $6.92 Typical High $9.12 | Facility | JZ · No drug discarded | $1.02 | $6.92 | $9.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.27 Median $0.28 Typical High $0.28 | Professional | 52 · Reduced service | $0.27 | $0.28 | $0.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 53 · Discontinued | $0.11 | $0.11 | $0.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.08 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.05 | $0.06 | $0.06 |
Where Texas sits
The same service costs 6.3 times more in Texas than in Mississippi. 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· 1st of 51
$3.39
TX $3.39MS $0.54
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.