How much rates vary
Facilitymedian $22 · 10th to 90th $11 to $44Professionalmedian $12 · 10th to 90th $9 to $68
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 $12.02 Median $17.38 Typical High $26.92 | Facility | None | $12.02 | $17.38 | $26.92 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $13.18 | Professional | None | $12.02 | $12.02 | $13.18 |
BCBS Texas Setting Facility Modifier None Typical Low $9.77 Median $22.91 Typical High $43.65 | Facility | None | $9.77 | $22.91 | $43.65 |
BCBS Texas Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $12.02 Median $28.18 Typical High $39.81 | Facility | None | $12.02 | $28.18 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Moda Health Setting Facility Modifier None Typical Low $12.30 Median $17.78 Typical High $57.54 | Facility | None | $12.30 | $17.78 | $57.54 |
Moda Health Setting Professional Modifier None Typical Low $12.02 Median $12.59 Typical High $13.80 | Professional | None | $12.02 | $12.59 | $13.80 |
Molina Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
Providence Setting Facility Modifier None Typical Low $12.02 Median $17.38 Typical High $102.33 | Facility | None | $12.02 | $17.38 | $102.33 |
Providence Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
United Setting Professional Modifier None Typical Low $12.30 Median $13.49 Typical High $67.61 | Professional | None | $12.30 | $13.49 | $67.61 |
Wellpoint Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
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 $6.03 Median $9.33 Typical High $13.49 | Facility | 52 · Reduced service | $6.03 | $9.33 | $13.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.40 Median $3.72 Typical High $5.37 | Facility | 53 · Discontinued | $2.40 | $3.72 | $5.37 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.82 Median $2.82 Typical High $4.07 | Facility | 55 · Aftercare only | $1.82 | $2.82 | $4.07 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.86 Typical High $2.69 | Facility | 56 · Pre-op care only | $1.20 | $1.86 | $2.69 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.03 Median $6.03 Typical High $6.61 | Professional | 52 · Reduced service | $6.03 | $6.03 | $6.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.45 Typical High $2.63 | Professional | 53 · Discontinued | $2.40 | $2.45 | $2.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $2.00 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.23 Typical High $1.32 | Professional | 56 · Pre-op care only | $1.20 | $1.23 | $1.32 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $6.17 Median $6.31 Typical High $6.46 | Professional | 52 · Reduced service | $6.17 | $6.31 | $6.46 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.51 Typical High $2.57 | Professional | 53 · Discontinued | $2.45 | $2.51 | $2.57 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $1.86 Typical High $1.95 | Professional | 55 · Aftercare only | $1.86 | $1.86 | $1.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.26 Typical High $1.29 | Professional | 56 · Pre-op care only | $1.23 | $1.26 | $1.29 |
Where Texas sits
The same service costs 1.9 times more in Alaska than in Pennsylvania. 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· 3rd of 51
$18.20
AK $22.39PA $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.