How much rates vary
Facilitymedian $7 · 10th to 90th $3 to $13Professionalmedian $3 · 10th to 90th $3 to $8
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 $2.82 Median $4.17 Typical High $6.46 | Facility | None | $2.82 | $4.17 | $6.46 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $3.09 | Professional | None | $2.82 | $2.82 | $3.09 |
BCBS Texas Setting Facility Modifier None Typical Low $3.02 Median $7.41 Typical High $13.80 | Facility | None | $3.02 | $7.41 | $13.80 |
BCBS Texas Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $2.82 Median $5.37 Typical High $8.91 | Facility | None | $2.82 | $5.37 | $8.91 |
Cigna Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
Moda Health Setting Facility Modifier None Typical Low $3.02 Median $9.77 Typical High $12.59 | Facility | None | $3.02 | $9.77 | $12.59 |
Moda Health Setting Professional Modifier None Typical Low $2.95 Median $3.02 Typical High $3.24 | Professional | None | $2.95 | $3.02 | $3.24 |
Molina Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
Providence Setting Facility Modifier None Typical Low $2.82 Median $3.98 Typical High $23.99 | Facility | None | $2.82 | $3.98 | $23.99 |
Providence Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
United Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Wellpoint Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | None | $2.45 | $2.45 | $2.45 |
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 $1.41 Median $2.34 Typical High $3.24 | Facility | 52 · Reduced service | $1.41 | $2.34 | $3.24 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.56 Median $0.93 Typical High $1.29 | Facility | 53 · Discontinued | $0.56 | $0.93 | $1.29 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.42 Median $0.71 Typical High $0.98 | Facility | 55 · Aftercare only | $0.42 | $0.71 | $0.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.47 Typical High $0.65 | Facility | 56 · Pre-op care only | $0.28 | $0.47 | $0.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.41 Median $1.45 Typical High $1.55 | Professional | 52 · Reduced service | $1.41 | $1.45 | $1.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.56 Typical High $0.62 | Professional | 53 · Discontinued | $0.56 | $0.56 | $0.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.42 Median $0.43 Typical High $0.47 | Professional | 55 · Aftercare only | $0.42 | $0.43 | $0.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.31 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.48 Median $1.51 Typical High $1.55 | Professional | 52 · Reduced service | $1.48 | $1.51 | $1.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.60 Typical High $0.62 | Professional | 53 · Discontinued | $0.59 | $0.60 | $0.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.45 Typical High $0.46 | Professional | 55 · Aftercare only | $0.44 | $0.45 | $0.46 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.31 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.31 |
Where Texas sits
The same service costs 7.4 times more in Wyoming than in Kansas. 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
$6.17
WY $20.42KS $2.75
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.