How much rates vary
Facilitymedian $1 · 10th to 90th $1 to $9Professionalmedian $2 · 10th to 90th $0 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 $2.14 Median $2.34 Typical High $3.47 | Facility | None | $2.14 | $2.34 | $3.47 |
Aetna Setting Professional Modifier None Typical Low $2.29 Median $2.34 Typical High $2.51 | Professional | None | $2.29 | $2.34 | $2.51 |
BCBS Texas Setting Facility Modifier None Typical Low $0.37 Median $0.93 Typical High $1.78 | Facility | None | $0.37 | $0.93 | $1.78 |
BCBS Texas Setting Professional Modifier None Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | None | $0.43 | $0.43 | $0.43 |
Baylor Scott & White Setting Facility Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Facility | None | $1.78 | $1.78 | $1.78 |
Christus Setting Facility Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Facility | None | $1.02 | $1.02 | $1.02 |
Cigna Setting Facility Modifier None Typical Low $2.29 Median $4.37 Typical High $7.41 | Facility | None | $2.29 | $4.37 | $7.41 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
Moda Health Setting Facility Modifier None Typical Low $2.24 Median $6.46 Typical High $11.22 | Facility | None | $2.24 | $6.46 | $11.22 |
Moda Health Setting Professional Modifier None Typical Low $1.66 Median $1.70 Typical High $2.29 | Professional | None | $1.66 | $1.70 | $2.29 |
Molina Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
Providence Setting Facility Modifier None Typical Low $1.48 Median $2.75 Typical High $19.50 | Facility | None | $1.48 | $2.75 | $19.50 |
Providence Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
United Setting Professional Modifier None Typical Low $1.66 Median $1.78 Typical High $1.86 | Professional | None | $1.66 | $1.78 | $1.86 |
Wellpoint Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | None | $1.41 | $1.41 | $1.41 |
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 $1.10 Median $1.32 Typical High $1.82 | Facility | 52 · Reduced service | $1.10 | $1.32 | $1.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.44 Median $0.52 Typical High $0.72 | Facility | 53 · Discontinued | $0.44 | $0.52 | $0.72 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.33 Median $0.40 Typical High $0.54 | Facility | 55 · Aftercare only | $0.33 | $0.40 | $0.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.27 Typical High $0.36 | Facility | 56 · Pre-op care only | $0.22 | $0.27 | $0.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.15 Median $1.17 Typical High $1.20 | Professional | 52 · Reduced service | $1.15 | $1.17 | $1.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.46 Median $0.47 Typical High $0.50 | Professional | 53 · Discontinued | $0.46 | $0.47 | $0.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.35 Median $0.35 Typical High $0.38 | Professional | 55 · Aftercare only | $0.35 | $0.35 | $0.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.23 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.23 | $0.23 | $0.25 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $0.78 Median $2.88 Typical High $3.89 | Facility | JZ · No drug discarded | $0.78 | $2.88 | $3.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.83 Median $0.83 Typical High $0.87 | Professional | 52 · Reduced service | $0.83 | $0.83 | $0.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.33 Median $0.34 Typical High $0.35 | Professional | 53 · Discontinued | $0.33 | $0.34 | $0.35 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.25 Median $0.25 Typical High $0.26 | Professional | 55 · Aftercare only | $0.25 | $0.25 | $0.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.17 | $0.17 | $0.17 |
Where Texas sits
The same service costs 3.8 times more in Alaska 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· 48th of 51
$1.66
AK $4.27OK $1.12
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.