How much rates vary
Facilitymedian $65 · 10th to 90th $13 to $126Professionalmedian $37 · 10th to 90th $36 to $38
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 $37.15 Median $53.70 Typical High $77.62 | Facility | None | $37.15 | $53.70 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $37.15 Typical High $42.66 | Professional | None | $36.31 | $37.15 | $42.66 |
BCBS Texas Setting Facility Modifier None Typical Low $12.02 Median $66.07 Typical High $125.89 | Facility | None | $12.02 | $66.07 | $125.89 |
BCBS Texas Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $57.54 Typical High $123.03 | Facility | None | $38.02 | $57.54 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Moda Health Setting Facility Modifier None Typical Low $36.31 Median $64.57 Typical High $208.93 | Facility | None | $36.31 | $64.57 | $208.93 |
Moda Health Setting Professional Modifier None Typical Low $36.31 Median $37.15 Typical High $37.15 | Professional | None | $36.31 | $37.15 | $37.15 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $42.66 Typical High $42.66 | Professional | None | $30.20 | $42.66 | $42.66 |
Providence Setting Facility Modifier None Typical Low $1.35 Median $44.67 Typical High $323.59 | Facility | None | $1.35 | $44.67 | $323.59 |
Providence Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
United Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Wellpoint Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
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 $18.62 Median $28.18 Typical High $38.90 | Facility | 52 · Reduced service | $18.62 | $28.18 | $38.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.41 Median $11.48 Typical High $15.49 | Facility | 53 · Discontinued | $7.41 | $11.48 | $15.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.50 Median $8.51 Typical High $11.75 | Facility | 55 · Aftercare only | $5.50 | $8.51 | $11.75 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.72 Median $5.75 Typical High $7.76 | Facility | 56 · Pre-op care only | $3.72 | $5.75 | $7.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $18.62 Typical High $21.38 | Professional | 52 · Reduced service | $18.20 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.41 Typical High $8.51 | Professional | 53 · Discontinued | $7.24 | $7.41 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.50 Typical High $6.46 | Professional | 55 · Aftercare only | $5.37 | $5.50 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.72 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.63 | $3.72 | $4.27 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $18.20 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.41 Typical High $7.41 | Professional | 53 · Discontinued | $7.24 | $7.41 | $7.41 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $5.37 | $5.50 | $5.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.72 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.63 | $3.72 | $3.72 |
Where Texas sits
The same service costs 20.4 times more in Arizona than in Hawaii. 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
$45.71
AZ $60.26HI $2.95
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.