How much rates vary
Facilitymedian $8 · 10th to 90th $3 to $15Professionalmedian $3 · 10th to 90th $3 to $4
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 $3.47 Median $5.13 Typical High $7.08 | Facility | None | $3.47 | $5.13 | $7.08 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.80 | Professional | None | $3.47 | $3.47 | $3.80 |
BCBS Setting Facility Modifier None Typical Low $3.72 Median $8.32 Typical High $15.85 | Facility | None | $3.72 | $8.32 | $15.85 |
BCBS Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | None | $3.63 | $3.63 | $3.63 |
Cigna Setting Facility Modifier None Typical Low $3.47 Median $6.61 Typical High $10.96 | Facility | None | $3.47 | $6.61 | $10.96 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Moda Health Setting Facility Modifier None Typical Low $3.24 Median $4.27 Typical High $7.94 | Facility | None | $3.24 | $4.27 | $7.94 |
Moda Health Setting Professional Modifier None Typical Low $3.24 Median $3.31 Typical High $3.55 | Professional | None | $3.24 | $3.31 | $3.55 |
Molina Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Providence Setting Facility Modifier None Typical Low $3.47 Median $4.90 Typical High $29.51 | Facility | None | $3.47 | $4.90 | $29.51 |
Providence Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
United Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Facility | None | $3.47 | $3.47 | $3.47 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Wellpoint Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
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 $1.74 Median $2.57 Typical High $3.55 | Facility | 52 · Reduced service | $1.74 | $2.57 | $3.55 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.69 Median $1.05 Typical High $1.41 | Facility | 53 · Discontinued | $0.69 | $1.05 | $1.41 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.52 Median $0.78 Typical High $1.07 | Facility | 55 · Aftercare only | $0.52 | $0.78 | $1.07 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.52 Typical High $0.71 | Facility | 56 · Pre-op care only | $0.35 | $0.52 | $0.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.74 Median $1.74 Typical High $1.91 | Professional | 52 · Reduced service | $1.74 | $1.74 | $1.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.69 Median $0.71 Typical High $0.76 | Professional | 53 · Discontinued | $0.69 | $0.71 | $0.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.56 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.35 Typical High $0.38 | Professional | 56 · Pre-op care only | $0.35 | $0.35 | $0.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.62 Median $1.62 Typical High $1.70 | Professional | 52 · Reduced service | $1.62 | $1.62 | $1.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.66 Typical High $0.68 | Professional | 53 · Discontinued | $0.65 | $0.66 | $0.68 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.49 Typical High $0.51 | Professional | 55 · Aftercare only | $0.49 | $0.49 | $0.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.33 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.33 | $0.33 | $0.34 |
Where Texas sits
The same service costs 562.3 times more in Alabama than in Oklahoma. 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· 4th of 51
$5.01
AL $1,622OK $2.88
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.