How much rates vary
Facilitymedian $16 · 10th to 90th $6 to $49Professionalmedian $13 · 10th to 90th $5 to $19
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 $16.98 Median $19.05 Typical High $26.30 | Facility | None | $16.98 | $19.05 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.50 | Professional | None | $19.05 | $19.05 | $19.50 |
BCBS Texas Setting Facility Modifier None Typical Low $5.01 Median $12.59 Typical High $23.44 | Facility | None | $5.01 | $12.59 | $23.44 |
BCBS Texas Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | None | $5.37 | $5.37 | $5.37 |
Baylor Scott & White Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $23.44 | Facility | None | $10.72 | $10.72 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $19.05 Median $35.48 Typical High $60.26 | Facility | None | $19.05 | $35.48 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
Moda Health Setting Facility Modifier None Typical Low $8.71 Median $21.38 Typical High $66.07 | Facility | None | $8.71 | $21.38 | $66.07 |
Moda Health Setting Professional Modifier None Typical Low $12.02 Median $12.30 Typical High $19.05 | Professional | None | $12.02 | $12.30 | $19.05 |
Molina Setting Professional Modifier None Typical Low $8.51 Median $9.55 Typical High $13.18 | Professional | None | $8.51 | $9.55 | $13.18 |
Providence Setting Facility Modifier None Typical Low $18.20 Median $26.92 Typical High $162.18 | Facility | None | $18.20 | $26.92 | $162.18 |
Providence Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
United Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Wellpoint Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
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 $7.94 Median $9.77 Typical High $13.18 | Facility | 52 · Reduced service | $7.94 | $9.77 | $13.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.16 Median $3.89 Typical High $5.25 | Facility | 53 · Discontinued | $3.16 | $3.89 | $5.25 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.40 Median $2.88 Typical High $3.98 | Facility | 55 · Aftercare only | $2.40 | $2.88 | $3.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.95 Typical High $2.63 | Facility | 56 · Pre-op care only | $1.58 | $1.95 | $2.63 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.55 Median $9.55 Typical High $9.77 | Professional | 52 · Reduced service | $9.55 | $9.55 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $3.80 Typical High $3.89 | Professional | 53 · Discontinued | $3.80 | $3.80 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.88 Typical High $2.95 | Professional | 55 · Aftercare only | $2.82 | $2.88 | $2.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $1.91 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.91 | $1.91 | $1.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $6.03 Median $6.17 Typical High $6.31 | Professional | 52 · Reduced service | $6.03 | $6.17 | $6.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.45 Typical High $2.51 | Professional | 53 · Discontinued | $2.45 | $2.45 | $2.51 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $1.91 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $1.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.23 Typical High $1.26 | Professional | 56 · Pre-op care only | $1.23 | $1.23 | $1.26 |
Where Texas sits
The same service costs 2.7 times more in Wyoming than in Maryland. 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· 43rd of 51
$15.49
WY $32.36MD $12.02
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.