How much rates vary
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 $20.42 Median $35.48 Typical High $77.62 | Facility | None | $20.42 | $35.48 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.89 | Professional | None | $20.42 | $20.42 | $20.89 |
BCBS Texas Setting Facility Modifier None Typical Low $69.18 Median $173.78 Typical High $269.15 | Facility | None | $69.18 | $173.78 | $269.15 |
BCBS Texas Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $20.42 Median $39.81 Typical High $64.57 | Facility | None | $20.42 | $39.81 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Moda Health Setting Facility Modifier None Typical Low $32.36 Median $35.48 Typical High $77.62 | Facility | None | $32.36 | $35.48 | $77.62 |
Moda Health Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $33.88 | Professional | None | $32.36 | $32.36 | $33.88 |
Molina Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Providence Setting Facility Modifier None Typical Low $20.42 Median $30.20 Typical High $173.78 | Facility | None | $20.42 | $30.20 | $173.78 |
Providence Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
United Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Wellpoint Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
8 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 Professional Modifier 52 · Reduced service Typical Low $10.23 Median $10.23 Typical High $10.47 | Professional | 52 · Reduced service | $10.23 | $10.23 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $4.17 | Professional | 53 · Discontinued | $4.07 | $4.07 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.09 Typical High $3.16 | Professional | 55 · Aftercare only | $3.02 | $3.09 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $2.09 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $2.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $16.22 Typical High $16.60 | Professional | 52 · Reduced service | $16.22 | $16.22 | $16.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.61 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.61 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.90 Typical High $5.01 | Professional | 55 · Aftercare only | $4.79 | $4.90 | $5.01 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.31 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.31 |
Where Texas sits
The same service costs 3.8 times more in Oklahoma than in Delaware. 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
$67.61
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.