How much rates vary
Facilitymedian $4 · 10th to 90th $1 to $9Professionalmedian $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 $1.38 Median $1.41 Typical High $2.29 | Facility | None | $1.38 | $1.41 | $2.29 |
Aetna Setting Professional Modifier None Typical Low $1.38 Median $1.41 Typical High $1.55 | Professional | None | $1.38 | $1.41 | $1.55 |
BCBS Texas Setting Facility Modifier None Typical Low $0.42 Median $0.83 Typical High $1.74 | Facility | None | $0.42 | $0.83 | $1.74 |
BCBS Texas Setting Professional Modifier None Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | None | $0.52 | $0.52 | $0.52 |
Christus Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Facility | None | $4.37 | $4.37 | $4.37 |
Cigna Setting Facility Modifier None Typical Low $1.38 Median $2.63 Typical High $4.37 | Facility | None | $1.38 | $2.63 | $4.37 |
Cigna Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
Moda Health Setting Facility Modifier None Typical Low $2.09 Median $5.89 Typical High $9.33 | Facility | None | $2.09 | $5.89 | $9.33 |
Moda Health Setting Professional Modifier None Typical Low $1.15 Median $1.17 Typical High $1.62 | Professional | None | $1.15 | $1.17 | $1.62 |
Molina Setting Professional Modifier None Typical Low $1.17 Median $1.20 Typical High $1.38 | Professional | None | $1.17 | $1.20 | $1.38 |
Providence Setting Facility Modifier None Typical Low $0.93 Median $1.70 Typical High $11.75 | Facility | None | $0.93 | $1.70 | $11.75 |
Providence Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
United Setting Professional Modifier None Typical Low $1.15 Median $1.15 Typical High $1.15 | Professional | None | $1.15 | $1.15 | $1.15 |
Wellpoint Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | None | $1.20 | $1.20 | $1.20 |
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 $0.71 Median $0.91 Typical High $1.26 | Facility | 52 · Reduced service | $0.71 | $0.91 | $1.26 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.28 Median $0.37 Typical High $0.51 | Facility | 53 · Discontinued | $0.28 | $0.37 | $0.51 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.21 Median $0.26 Typical High $0.38 | Facility | 55 · Aftercare only | $0.21 | $0.26 | $0.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.18 Typical High $0.25 | Facility | 56 · Pre-op care only | $0.14 | $0.18 | $0.25 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.71 Median $0.71 Typical High $0.76 | Professional | 52 · Reduced service | $0.71 | $0.71 | $0.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $0.30 | Professional | 53 · Discontinued | $0.28 | $0.28 | $0.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.23 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.58 Median $0.59 Typical High $0.62 | Professional | 52 · Reduced service | $0.58 | $0.59 | $0.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.23 Median $0.23 Typical High $0.24 | Professional | 53 · Discontinued | $0.23 | $0.23 | $0.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.18 Typical High $0.18 | Professional | 55 · Aftercare only | $0.17 | $0.18 | $0.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.12 | $0.12 | $0.12 |
Where Texas sits
The same service costs 5.9 times more in Vermont 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· 3rd of 51
$2.95
VT $5.89OK $1.00
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.