How much rates vary
Facilitymedian $5 · 10th to 90th $0 to $10Professionalmedian $4 · 10th to 90th $0 to $4
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 $3.63 Median $3.72 Typical High $6.92 | Facility | None | $3.63 | $3.72 | $6.92 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $3.72 Typical High $4.37 | Professional | None | $3.63 | $3.72 | $4.37 |
Ambetter Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | None | $3.31 | $3.31 | $3.31 |
BCBS Texas Setting Facility Modifier None Typical Low $0.30 Median $0.78 Typical High $1.91 | Facility | None | $0.30 | $0.78 | $1.91 |
BCBS Texas Setting Professional Modifier None Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | None | $0.30 | $0.30 | $0.30 |
Christus Setting Facility Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Facility | None | $10.23 | $10.23 | $10.23 |
Cigna Setting Facility Modifier None Typical Low $3.63 Median $6.92 Typical High $11.75 | Facility | None | $3.63 | $6.92 | $11.75 |
Cigna Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | None | $3.63 | $3.63 | $3.63 |
Moda Health Setting Facility Modifier None Typical Low $3.31 Median $6.46 Typical High $21.88 | Facility | None | $3.31 | $6.46 | $21.88 |
Moda Health Setting Professional Modifier None Typical Low $3.31 Median $3.63 Typical High $5.25 | Professional | None | $3.31 | $3.63 | $5.25 |
Molina Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
Providence Setting Facility Modifier None Typical Low $2.45 Median $4.37 Typical High $30.90 | Facility | None | $2.45 | $4.37 | $30.90 |
Providence Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | None | $3.63 | $3.63 | $3.63 |
United Setting Professional Modifier None Typical Low $3.31 Median $3.63 Typical High $3.72 | Professional | None | $3.31 | $3.63 | $3.72 |
Wellpoint Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
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 $1.82 Median $2.69 Typical High $3.63 | Facility | 52 · Reduced service | $1.82 | $2.69 | $3.63 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.72 Median $1.07 Typical High $1.45 | Facility | 53 · Discontinued | $0.72 | $1.07 | $1.45 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.55 Median $0.79 Typical High $1.10 | Facility | 55 · Aftercare only | $0.55 | $0.79 | $1.10 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.52 Typical High $0.72 | Facility | 56 · Pre-op care only | $0.36 | $0.52 | $0.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.82 Median $1.82 Typical High $2.00 | Professional | 52 · Reduced service | $1.82 | $1.82 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.74 Typical High $0.79 | Professional | 53 · Discontinued | $0.72 | $0.74 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.55 Median $0.55 Typical High $0.60 | Professional | 55 · Aftercare only | $0.55 | $0.55 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.37 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.36 | $0.37 | $0.40 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $0.44 Median $1.86 Typical High $6.92 | Facility | JZ · No drug discarded | $0.44 | $1.86 | $6.92 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.66 Median $1.70 Typical High $1.74 | Professional | 52 · Reduced service | $1.66 | $1.70 | $1.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.68 Typical High $0.71 | Professional | 53 · Discontinued | $0.68 | $0.68 | $0.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.50 Median $0.51 Typical High $0.52 | Professional | 55 · Aftercare only | $0.50 | $0.51 | $0.52 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.34 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.33 | $0.34 | $0.35 |
Where Texas sits
The same service costs 2.5 times more in Alaska 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· 21st of 51
$3.72
AK $6.46OK $2.57
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.