How much rates vary
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 $17.78 Median $19.50 Typical High $42.66 | Facility | None | $17.78 | $19.50 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $18.20 Typical High $18.62 | Professional | None | $17.78 | $18.20 | $18.62 |
BCBS Texas Setting Facility Modifier None Typical Low $19.50 Median $46.77 Typical High $79.43 | Facility | None | $19.50 | $46.77 | $79.43 |
BCBS Texas Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Cigna Setting Facility Modifier None Typical Low $17.78 Median $34.67 Typical High $57.54 | Facility | None | $17.78 | $34.67 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Moda Health Setting Facility Modifier None Typical Low $17.78 Median $19.50 Typical High $42.66 | Facility | None | $17.78 | $19.50 | $42.66 |
Moda Health Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $18.62 | Professional | None | $17.78 | $17.78 | $18.62 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $17.78 Median $25.70 Typical High $154.88 | Facility | None | $17.78 | $25.70 | $154.88 |
Providence Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
United Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Wellpoint Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
8 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 Professional Modifier 52 · Reduced service Typical Low $8.91 Median $9.12 Typical High $9.33 | Professional | 52 · Reduced service | $8.91 | $9.12 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.63 Typical High $3.72 | Professional | 53 · Discontinued | $3.55 | $3.63 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $2.75 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $1.82 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.78 | $1.82 | $1.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $8.71 Median $8.91 Typical High $9.12 | Professional | 52 · Reduced service | $8.71 | $8.91 | $9.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.55 Typical High $3.63 | Professional | 53 · Discontinued | $3.55 | $3.55 | $3.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $2.63 Typical High $2.69 | Professional | 55 · Aftercare only | $2.63 | $2.63 | $2.69 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $1.78 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.78 | $1.78 | $1.82 |
Where Texas sits
The same service costs 1.5 times more in Alaska than in Rhode Island. 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· 12th of 51
$20.42
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.