How much rates vary
Facilitymedian $25 · 10th to 90th $8 to $41Professionalmedian $4 · 10th to 90th $4 to $7
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 $4.47 Median $5.89 Typical High $9.12 | Facility | None | $4.47 | $5.89 | $9.12 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $4.57 Typical High $5.01 | Professional | None | $4.47 | $4.57 | $5.01 |
BCBS Texas Setting Facility Modifier None Typical Low $13.80 Median $32.36 Typical High $44.67 | Facility | None | $13.80 | $32.36 | $44.67 |
BCBS Texas Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
Christus Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Cigna Setting Facility Modifier None Typical Low $4.47 Median $10.72 Typical High $14.79 | Facility | None | $4.47 | $10.72 | $14.79 |
Cigna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Moda Health Setting Facility Modifier None Typical Low $7.41 Median $23.99 Typical High $40.74 | Facility | None | $7.41 | $23.99 | $40.74 |
Moda Health Setting Professional Modifier None Typical Low $4.17 Median $4.27 Typical High $4.57 | Professional | None | $4.17 | $4.27 | $4.57 |
Molina Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
Providence Setting Facility Modifier None Typical Low $4.47 Median $6.46 Typical High $38.90 | Facility | None | $4.47 | $6.46 | $38.90 |
Providence Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
United Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | None | $4.17 | $4.17 | $4.17 |
Wellpoint Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | None | $4.57 | $4.57 | $4.57 |
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 $2.24 Median $3.39 Typical High $4.57 | Facility | 52 · Reduced service | $2.24 | $3.39 | $4.57 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.89 Median $1.35 Typical High $1.82 | Facility | 53 · Discontinued | $0.89 | $1.35 | $1.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.68 Median $1.00 Typical High $1.38 | Facility | 55 · Aftercare only | $0.68 | $1.00 | $1.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.68 Typical High $0.91 | Facility | 56 · Pre-op care only | $0.45 | $0.68 | $0.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.24 Median $2.29 Typical High $2.45 | Professional | 52 · Reduced service | $2.24 | $2.29 | $2.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $0.91 Typical High $1.00 | Professional | 53 · Discontinued | $0.89 | $0.91 | $1.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $0.68 Typical High $0.74 | Professional | 55 · Aftercare only | $0.68 | $0.68 | $0.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.46 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.45 | $0.46 | $0.50 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $33.88 Median $34.67 Typical High $46.77 | Facility | JZ · No drug discarded | $33.88 | $34.67 | $46.77 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.09 Median $2.14 Typical High $2.19 | Professional | 52 · Reduced service | $2.09 | $2.14 | $2.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $0.85 Typical High $0.87 | Professional | 53 · Discontinued | $0.83 | $0.85 | $0.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.63 Median $0.65 Typical High $0.66 | Professional | 55 · Aftercare only | $0.63 | $0.65 | $0.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.42 Typical High $0.44 | Professional | 56 · Pre-op care only | $0.42 | $0.42 | $0.44 |
Where Texas sits
The same service costs 5.9 times more in Texas than in Rhode Island. 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
$24.55
TX $24.55RI $4.17
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.