How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $7Professionalmedian $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 $0.79 Median $1.02 Typical High $1.66 | Facility | None | $0.79 | $1.02 | $1.66 |
Aetna Setting Professional Modifier None Typical Low $0.78 Median $0.79 Typical High $0.83 | Professional | None | $0.78 | $0.79 | $0.83 |
BCBS Texas Setting Facility Modifier None Typical Low $0.66 Median $2.40 Typical High $4.57 | Facility | None | $0.66 | $2.40 | $4.57 |
Cigna Setting Facility Modifier None Typical Low $0.71 Median $1.07 Typical High $2.29 | Facility | None | $0.71 | $1.07 | $2.29 |
Cigna Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | None | $0.71 | $0.71 | $0.71 |
Moda Health Setting Facility Modifier None Typical Low $0.79 Median $2.45 Typical High $7.41 | Facility | None | $0.79 | $2.45 | $7.41 |
Moda Health Setting Professional Modifier None Typical Low $0.71 Median $0.79 Typical High $0.79 | Professional | None | $0.71 | $0.79 | $0.79 |
Molina Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
Providence Setting Facility Modifier None Typical Low $0.38 Median $0.83 Typical High $6.03 | Facility | None | $0.38 | $0.83 | $6.03 |
Providence Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | None | $0.71 | $0.71 | $0.71 |
United Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | None | $0.71 | $0.71 | $0.71 |
Wellpoint Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | None | $0.71 | $0.71 | $0.71 |
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 $0.40 Median $0.62 Typical High $0.83 | Facility | 52 · Reduced service | $0.40 | $0.62 | $0.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.16 Median $0.23 Typical High $0.33 | Facility | 53 · Discontinued | $0.16 | $0.23 | $0.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.12 Median $0.17 Typical High $0.25 | Facility | 55 · Aftercare only | $0.12 | $0.17 | $0.25 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.12 Typical High $0.17 | Facility | 56 · Pre-op care only | $0.08 | $0.12 | $0.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.39 Median $0.40 Typical High $0.42 | Professional | 52 · Reduced service | $0.39 | $0.40 | $0.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.15 Median $0.16 Typical High $0.17 | Professional | 53 · Discontinued | $0.15 | $0.16 | $0.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.13 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.08 |
Moda Health Setting Facility Modifier JW · Drug discarded Typical Low $1.00 Median $2.09 Typical High $8.71 | Facility | JW · Drug discarded | $1.00 | $2.09 | $8.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.39 Median $0.40 Typical High $0.40 | Professional | 52 · Reduced service | $0.39 | $0.40 | $0.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.15 Median $0.16 Typical High $0.16 | Professional | 53 · Discontinued | $0.15 | $0.16 | $0.16 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.08 |
Where Texas sits
The same service costs 35.5 times more in Oklahoma than in South Carolina. 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· 2nd of 51
$1.86
OK $5.01SC $0.14
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.