How much rates vary
Facilitymedian $6 · 10th to 90th $0 to $25Professionalmedian $4 · 10th to 90th $0 to $8
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 $6.17 Median $8.13 Typical High $9.77 | Facility | None | $6.17 | $8.13 | $9.77 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.32 | Professional | None | $8.13 | $8.13 | $8.32 |
BCBS Texas Setting Facility Modifier None Typical Low $0.08 Median $0.19 Typical High $0.35 | Facility | None | $0.08 | $0.19 | $0.35 |
BCBS Texas Setting Professional Modifier None Typical Low $0.21 Median $0.21 Typical High $0.35 | Professional | None | $0.21 | $0.21 | $0.35 |
Baylor Scott & White Setting Facility Modifier None Typical Low $3.31 Median $4.47 Typical High $23.99 | Facility | None | $3.31 | $4.47 | $23.99 |
Christus Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $15.14 Typical High $25.70 | Facility | None | $8.13 | $15.14 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Moda Health Setting Facility Modifier None Typical Low $5.01 Median $8.51 Typical High $32.36 | Facility | None | $5.01 | $8.51 | $32.36 |
Moda Health Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $8.13 | Professional | None | $4.47 | $4.47 | $8.13 |
Molina Setting Professional Modifier None Typical Low $4.57 Median $30.20 Typical High $30.20 | Professional | None | $4.57 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $3.89 Median $9.77 Typical High $69.18 | Facility | None | $3.89 | $9.77 | $69.18 |
Providence Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
United Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Wellpoint Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
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 $2.95 Median $4.07 Typical High $4.79 | Facility | 52 · Reduced service | $2.95 | $4.07 | $4.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.17 Median $1.62 Typical High $1.95 | Facility | 53 · Discontinued | $1.17 | $1.62 | $1.95 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.87 Median $1.20 Typical High $1.45 | Facility | 55 · Aftercare only | $0.87 | $1.20 | $1.45 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.58 Median $0.81 Typical High $0.98 | Facility | 56 · Pre-op care only | $0.58 | $0.81 | $0.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.07 Median $4.07 Typical High $4.17 | Professional | 52 · Reduced service | $4.07 | $4.07 | $4.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $1.66 | Professional | 53 · Discontinued | $1.62 | $1.62 | $1.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.20 Median $1.23 Typical High $1.26 | Professional | 55 · Aftercare only | $1.20 | $1.23 | $1.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $0.83 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $0.83 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $5.62 Median $29.51 Typical High $35.48 | Facility | JZ · No drug discarded | $5.62 | $29.51 | $35.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.24 Median $2.24 Typical High $2.34 | Professional | 52 · Reduced service | $2.24 | $2.24 | $2.34 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $0.89 Typical High $0.93 | Professional | 53 · Discontinued | $0.89 | $0.89 | $0.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $0.68 Typical High $0.69 | Professional | 55 · Aftercare only | $0.68 | $0.68 | $0.69 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.45 Typical High $0.46 | Professional | 56 · Pre-op care only | $0.45 | $0.45 | $0.46 |
Where Texas sits
The same service costs 10.7 times more in Minnesota 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· 41st of 51
$6.46
MN $28.18OK $2.63
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.