How much rates vary
Facilitymedian $17 · 10th to 90th $10 to $44Professionalmedian $8 · 10th to 90th $8 to $11
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 $7.76 Median $9.12 Typical High $16.98 | Facility | None | $7.76 | $9.12 | $16.98 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $8.71 | Professional | None | $7.76 | $7.76 | $8.71 |
Ambetter Setting Professional Modifier None Typical Low $6.61 Median $6.92 Typical High $8.13 | Professional | None | $6.61 | $6.92 | $8.13 |
BCBS Texas Setting Facility Modifier None Typical Low $10.72 Median $28.18 Typical High $47.86 | Facility | None | $10.72 | $28.18 | $47.86 |
BCBS Texas Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Christus Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Cigna Setting Facility Modifier None Typical Low $7.76 Median $14.79 Typical High $24.55 | Facility | None | $7.76 | $14.79 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
Moda Health Setting Facility Modifier None Typical Low $7.94 Median $25.12 Typical High $56.23 | Facility | None | $7.94 | $25.12 | $56.23 |
Moda Health Setting Professional Modifier None Typical Low $7.76 Median $8.32 Typical High $10.72 | Professional | None | $7.76 | $8.32 | $10.72 |
Molina Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Providence Setting Facility Modifier None Typical Low $7.76 Median $10.96 Typical High $66.07 | Facility | None | $7.76 | $10.96 | $66.07 |
Providence Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
United Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Wellpoint Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
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 $3.89 Median $6.61 Typical High $8.91 | Facility | 52 · Reduced service | $3.89 | $6.61 | $8.91 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.55 Median $2.63 Typical High $3.63 | Facility | 53 · Discontinued | $1.55 | $2.63 | $3.63 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.17 Median $1.95 Typical High $2.69 | Facility | 55 · Aftercare only | $1.17 | $1.95 | $2.69 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.78 Median $1.32 Typical High $1.78 | Facility | 56 · Pre-op care only | $0.78 | $1.32 | $1.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.89 Median $3.89 Typical High $4.27 | Professional | 52 · Reduced service | $3.89 | $3.89 | $4.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.55 Median $1.58 Typical High $1.70 | Professional | 53 · Discontinued | $1.55 | $1.58 | $1.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.17 Median $1.17 Typical High $1.29 | Professional | 55 · Aftercare only | $1.17 | $1.17 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $0.79 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.78 | $0.79 | $0.85 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $4.07 Median $4.17 Typical High $4.27 | Professional | 52 · Reduced service | $4.07 | $4.17 | $4.27 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.66 Typical High $1.70 | Professional | 53 · Discontinued | $1.62 | $1.66 | $1.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.26 Typical High $1.29 | Professional | 55 · Aftercare only | $1.23 | $1.26 | $1.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.83 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.81 | $0.83 | $0.85 |
Where Texas sits
The same service costs 2.6 times more in Texas 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· 1st of 51
$16.60
TX $16.60OK $6.46
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.