How much rates vary
Facilitymedian $41 · 10th to 90th $10 to $60Professionalmedian $22 · 10th to 90th $15 to $23
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 $22.91 Median $33.11 Typical High $47.86 | Facility | None | $22.91 | $33.11 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $23.44 Typical High $28.84 | Professional | None | $22.91 | $23.44 | $28.84 |
BCBS Texas Setting Facility Modifier None Typical Low $3.02 Median $23.99 Typical High $47.86 | Facility | None | $3.02 | $23.99 | $47.86 |
BCBS Texas Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | None | $15.49 | $15.49 | $15.49 |
Christus Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $43.65 Typical High $74.13 | Facility | None | $22.91 | $43.65 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Moda Health Setting Facility Modifier None Typical Low $22.39 Median $47.86 Typical High $87.10 | Facility | None | $22.39 | $47.86 | $87.10 |
Moda Health Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $24.55 | Professional | None | $22.39 | $22.39 | $24.55 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Providence Setting Facility Modifier None Typical Low $14.79 Median $27.54 Typical High $194.98 | Facility | None | $14.79 | $27.54 | $194.98 |
Providence Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
United Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Wellpoint Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
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 $11.48 Median $17.78 Typical High $23.99 | Facility | 52 · Reduced service | $11.48 | $17.78 | $23.99 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.57 Median $7.08 Typical High $9.55 | Facility | 53 · Discontinued | $4.57 | $7.08 | $9.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.47 Median $5.25 Typical High $7.24 | Facility | 55 · Aftercare only | $3.47 | $5.25 | $7.24 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.29 Median $3.55 Typical High $4.79 | Facility | 56 · Pre-op care only | $2.29 | $3.55 | $4.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.48 Median $11.75 Typical High $12.59 | Professional | 52 · Reduced service | $11.48 | $11.75 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.68 Typical High $5.13 | Professional | 53 · Discontinued | $4.57 | $4.68 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $3.47 Typical High $3.80 | Professional | 55 · Aftercare only | $3.47 | $3.47 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.34 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.29 | $2.34 | $2.51 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $11.75 Median $38.02 Typical High $91.20 | Facility | JZ · No drug discarded | $11.75 | $38.02 | $91.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.96 Median $11.22 Typical High $11.48 | Professional | 52 · Reduced service | $10.96 | $11.22 | $11.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.47 Typical High $4.57 | Professional | 53 · Discontinued | $4.47 | $4.47 | $4.57 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.39 Typical High $3.47 | Professional | 55 · Aftercare only | $3.31 | $3.39 | $3.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.24 Typical High $2.29 | Professional | 56 · Pre-op care only | $2.19 | $2.24 | $2.29 |
Where Texas sits
The same service costs 2.0 times more in Minnesota than in Hawaii. 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· 3rd of 51
$31.62
MN $39.81HI $19.95
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.