How much rates vary
Facilitymedian $6 · 10th to 90th $2 to $10Professionalmedian $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 $1.20 Median $1.26 Typical High $2.29 | Facility | None | $1.20 | $1.26 | $2.29 |
Aetna Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.35 | Professional | None | $1.23 | $1.23 | $1.35 |
BCBS Texas Setting Facility Modifier None Typical Low $2.51 Median $5.75 Typical High $10.00 | Facility | None | $2.51 | $5.75 | $10.00 |
BCBS Texas Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Cigna Setting Facility Modifier None Typical Low $1.23 Median $2.29 Typical High $3.89 | Facility | None | $1.23 | $2.29 | $3.89 |
Cigna Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | None | $1.23 | $1.23 | $1.23 |
Moda Health Setting Facility Modifier None Typical Low $1.70 Median $6.76 Typical High $10.23 | Facility | None | $1.70 | $6.76 | $10.23 |
Moda Health Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.23 | Professional | None | $1.10 | $1.10 | $1.23 |
Molina Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Providence Setting Facility Modifier None Typical Low $1.23 Median $1.78 Typical High $10.47 | Facility | None | $1.23 | $1.78 | $10.47 |
Providence Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | None | $1.23 | $1.23 | $1.23 |
United Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
Wellpoint Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
13 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 $0.62 Median $0.87 Typical High $1.20 | Facility | 52 · Reduced service | $0.62 | $0.87 | $1.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.24 Median $0.33 Typical High $0.48 | Facility | 53 · Discontinued | $0.24 | $0.33 | $0.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.18 Median $0.26 Typical High $0.36 | Facility | 55 · Aftercare only | $0.18 | $0.26 | $0.36 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.17 Typical High $0.24 | Facility | 56 · Pre-op care only | $0.12 | $0.17 | $0.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.62 Median $0.62 Typical High $0.68 | Professional | 52 · Reduced service | $0.62 | $0.62 | $0.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.24 Median $0.25 Typical High $0.27 | Professional | 53 · Discontinued | $0.24 | $0.25 | $0.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.18 Median $0.18 Typical High $0.20 | Professional | 55 · Aftercare only | $0.18 | $0.18 | $0.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.12 | $0.12 | $0.13 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $2.04 Median $7.59 Typical High $9.55 | Facility | JZ · No drug discarded | $2.04 | $7.59 | $9.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.55 Median $0.55 Typical High $0.58 | Professional | 52 · Reduced service | $0.55 | $0.55 | $0.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.23 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.17 Typical High $0.17 | Professional | 55 · Aftercare only | $0.16 | $0.17 | $0.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
Where Texas sits
The same service costs 3.8 times more in Texas than in Maryland. 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
$4.17
TX $4.17MD $1.10
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.