How much rates vary
Facilitymedian $4 · 10th to 90th $2 to $8Professionalmedian $1 · 10th to 90th $1 to $1
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 $1.10 Median $1.78 Typical High $2.57 | Facility | None | $1.10 | $1.78 | $2.57 |
Aetna Setting Professional Modifier None Typical Low $1.10 Median $1.12 Typical High $1.20 | Professional | None | $1.10 | $1.12 | $1.20 |
BCBS Texas Setting Facility Modifier None Typical Low $2.00 Median $4.79 Typical High $7.94 | Facility | None | $2.00 | $4.79 | $7.94 |
BCBS Texas Setting Professional Modifier None Typical Low $1.05 Median $1.05 Typical High $1.78 | Professional | None | $1.05 | $1.05 | $1.78 |
Cigna Setting Facility Modifier None Typical Low $1.10 Median $2.09 Typical High $3.55 | Facility | None | $1.10 | $2.09 | $3.55 |
Cigna Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
Moda Health Setting Facility Modifier None Typical Low $1.17 Median $1.70 Typical High $4.68 | Facility | None | $1.17 | $1.70 | $4.68 |
Moda Health Setting Professional Modifier None Typical Low $1.17 Median $1.20 Typical High $1.29 | Professional | None | $1.17 | $1.20 | $1.29 |
Molina Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | None | $1.41 | $1.41 | $1.41 |
Providence Setting Facility Modifier None Typical Low $1.10 Median $1.58 Typical High $9.33 | Facility | None | $1.10 | $1.58 | $9.33 |
Providence Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
United Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.17 | Professional | None | $1.17 | $1.17 | $1.17 |
Wellpoint Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | None | $1.35 | $1.35 | $1.35 |
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 $0.55 Median $0.93 Typical High $1.29 | Facility | 52 · Reduced service | $0.55 | $0.93 | $1.29 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.22 Median $0.38 Typical High $0.51 | Facility | 53 · Discontinued | $0.22 | $0.38 | $0.51 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.17 Median $0.28 Typical High $0.39 | Facility | 55 · Aftercare only | $0.17 | $0.28 | $0.39 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.18 Typical High $0.26 | Facility | 56 · Pre-op care only | $0.11 | $0.18 | $0.26 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.55 Median $0.56 Typical High $0.62 | Professional | 52 · Reduced service | $0.55 | $0.56 | $0.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.24 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.18 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.59 Median $0.60 Typical High $0.62 | Professional | 52 · Reduced service | $0.59 | $0.60 | $0.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.24 Median $0.24 Typical High $0.25 | Professional | 53 · Discontinued | $0.24 | $0.24 | $0.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | 55 · Aftercare only | $0.18 | $0.18 | $0.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.12 | $0.12 | $0.12 |
Where Texas sits
The same service costs 3.0 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· 2nd of 51
$2.40
OK $3.31DE $1.10
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.