How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $3Professionalmedian $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 $0.60 Median $0.93 Typical High $1.35 | Facility | None | $0.60 | $0.93 | $1.35 |
Aetna Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $0.66 | Professional | None | $0.60 | $0.60 | $0.66 |
BCBS Texas Setting Facility Modifier None Typical Low $0.62 Median $1.66 Typical High $3.16 | Facility | None | $0.62 | $1.66 | $3.16 |
BCBS Texas Setting Professional Modifier None Typical Low $0.68 Median $0.83 Typical High $1.38 | Professional | None | $0.68 | $0.83 | $1.38 |
Cigna Setting Facility Modifier None Typical Low $0.60 Median $1.12 Typical High $1.91 | Facility | None | $0.60 | $1.12 | $1.91 |
Cigna Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | None | $0.60 | $0.60 | $0.60 |
Moda Health Setting Facility Modifier None Typical Low $0.63 Median $1.38 Typical High $6.03 | Facility | None | $0.63 | $1.38 | $6.03 |
Moda Health Setting Professional Modifier None Typical Low $0.62 Median $0.63 Typical High $0.69 | Professional | None | $0.62 | $0.63 | $0.69 |
Molina Setting Professional Modifier None Typical Low $0.60 Median $0.63 Typical High $0.66 | Professional | None | $0.60 | $0.63 | $0.66 |
Providence Setting Facility Modifier None Typical Low $0.60 Median $0.87 Typical High $5.13 | Facility | None | $0.60 | $0.87 | $5.13 |
Providence Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | None | $0.60 | $0.60 | $0.60 |
United Setting Professional Modifier None Typical Low $0.62 Median $0.68 Typical High $0.69 | Professional | None | $0.62 | $0.68 | $0.69 |
Wellpoint Setting Professional Modifier None Typical Low $0.66 Median $0.66 Typical High $0.66 | Professional | None | $0.66 | $0.66 | $0.66 |
14 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 $0.30 Median $0.50 Typical High $0.68 | Facility | 52 · Reduced service | $0.30 | $0.50 | $0.68 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.12 Median $0.19 Typical High $0.27 | Facility | 53 · Discontinued | $0.12 | $0.19 | $0.27 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.09 Median $0.14 Typical High $0.20 | Facility | 55 · Aftercare only | $0.09 | $0.14 | $0.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.09 Typical High $0.14 | Facility | 56 · Pre-op care only | $0.06 | $0.09 | $0.14 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.30 Median $0.30 Typical High $0.33 | Professional | 52 · Reduced service | $0.30 | $0.30 | $0.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.12 Typical High $0.13 | Professional | 53 · Discontinued | $0.12 | $0.12 | $0.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.10 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.07 |
Moda Health Setting Facility Modifier JA · Given by IV Typical Low $1.78 Median $5.50 Typical High $6.76 | Facility | JA · Given by IV | $1.78 | $5.50 | $6.76 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $1.74 Median $2.00 Typical High $5.37 | Facility | JZ · No drug discarded | $1.74 | $2.00 | $5.37 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.31 Median $0.32 Typical High $0.33 | Professional | 52 · Reduced service | $0.31 | $0.32 | $0.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.13 Typical High $0.13 | Professional | 53 · Discontinued | $0.12 | $0.13 | $0.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.10 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.07 |
Where Texas sits
The same service costs 3.4 times more in Wyoming 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· 4th of 51
$1.12
WY $2.04DE $0.60
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.