How much rates vary
Facilitymedian $6 · 10th to 90th $2 to $13Professionalmedian $2 · 10th to 90th $1 to $2
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 $1.91 Median $2.34 Typical High $4.47 | Facility | None | $1.91 | $2.34 | $4.47 |
Aetna Setting Professional Modifier None Typical Low $1.91 Median $1.95 Typical High $2.14 | Professional | None | $1.91 | $1.95 | $2.14 |
BCBS Texas Setting Facility Modifier None Typical Low $1.45 Median $3.63 Typical High $7.24 | Facility | None | $1.45 | $3.63 | $7.24 |
BCBS Texas Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | None | $1.45 | $1.45 | $1.45 |
Christus Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Facility | None | $6.92 | $6.92 | $6.92 |
Cigna Setting Facility Modifier None Typical Low $1.91 Median $3.63 Typical High $6.17 | Facility | None | $1.91 | $3.63 | $6.17 |
Cigna Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | None | $1.91 | $1.91 | $1.91 |
Moda Health Setting Facility Modifier None Typical Low $2.34 Median $8.32 Typical High $16.98 | Facility | None | $2.34 | $8.32 | $16.98 |
Moda Health Setting Professional Modifier None Typical Low $1.91 Median $2.19 Typical High $2.40 | Professional | None | $1.91 | $2.19 | $2.40 |
Molina Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $2.19 | Professional | None | $1.91 | $1.91 | $2.19 |
Providence Setting Facility Modifier None Typical Low $1.91 Median $2.75 Typical High $16.22 | Facility | None | $1.91 | $2.75 | $16.22 |
Providence Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | None | $1.91 | $1.91 | $1.91 |
United Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
Wellpoint Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
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 $0.95 Median $1.74 Typical High $2.34 | Facility | 52 · Reduced service | $0.95 | $1.74 | $2.34 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.38 Median $0.69 Typical High $0.93 | Facility | 53 · Discontinued | $0.38 | $0.69 | $0.93 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.28 Median $0.52 Typical High $0.71 | Facility | 55 · Aftercare only | $0.28 | $0.52 | $0.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.34 Typical High $0.47 | Facility | 56 · Pre-op care only | $0.19 | $0.34 | $0.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.95 Median $0.98 Typical High $1.05 | Professional | 52 · Reduced service | $0.95 | $0.98 | $1.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.38 Median $0.39 Typical High $0.42 | Professional | 53 · Discontinued | $0.38 | $0.39 | $0.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $0.32 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $0.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.19 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.19 | $0.19 | $0.21 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $3.02 Median $9.55 Typical High $18.62 | Facility | JZ · No drug discarded | $3.02 | $9.55 | $18.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.07 Median $1.10 Typical High $1.12 | Professional | 52 · Reduced service | $1.07 | $1.10 | $1.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.44 Typical High $0.45 | Professional | 53 · Discontinued | $0.43 | $0.44 | $0.45 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.33 Typical High $0.34 | Professional | 55 · Aftercare only | $0.32 | $0.33 | $0.34 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $0.23 |
Where Texas sits
The same service costs 2.5 times more in Texas than in South Carolina. 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
$4.68
TX $4.68SC $1.91
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.