How much rates vary
Facilitymedian $51 · 10th to 90th $21 to $93Professionalmedian $21 · 10th to 90th $21 to $23
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 $21.38 Median $33.11 Typical High $45.71 | Facility | None | $21.38 | $33.11 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $21.88 Typical High $23.99 | Professional | None | $21.38 | $21.88 | $23.99 |
BCBS Texas Setting Facility Modifier None Typical Low $22.91 Median $57.54 Typical High $95.50 | Facility | None | $22.91 | $57.54 | $95.50 |
BCBS Texas Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $40.74 Typical High $69.18 | Facility | None | $21.38 | $40.74 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Moda Health Setting Facility Modifier None Typical Low $20.89 Median $25.70 Typical High $72.44 | Facility | None | $20.89 | $25.70 | $72.44 |
Moda Health Setting Professional Modifier None Typical Low $20.89 Median $21.38 Typical High $27.54 | Professional | None | $20.89 | $21.38 | $27.54 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Providence Setting Facility Modifier None Typical Low $21.38 Median $30.90 Typical High $186.21 | Facility | None | $21.38 | $30.90 | $186.21 |
Providence Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
United Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
United Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Wellpoint Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
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 $10.72 Median $16.60 Typical High $22.91 | Facility | 52 · Reduced service | $10.72 | $16.60 | $22.91 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.37 Median $6.76 Typical High $9.12 | Facility | 53 · Discontinued | $4.37 | $6.76 | $9.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.24 Median $5.01 Typical High $6.92 | Facility | 55 · Aftercare only | $3.24 | $5.01 | $6.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.14 Median $3.39 Typical High $4.57 | Facility | 56 · Pre-op care only | $2.14 | $3.39 | $4.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.72 Median $10.96 Typical High $12.02 | Professional | 52 · Reduced service | $10.72 | $10.96 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $4.79 | Professional | 53 · Discontinued | $4.37 | $4.37 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.31 Typical High $3.55 | Professional | 55 · Aftercare only | $3.24 | $3.31 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.19 Typical High $2.40 | Professional | 56 · Pre-op care only | $2.14 | $2.19 | $2.40 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $26.30 Median $56.23 Typical High $56.23 | Facility | JZ · No drug discarded | $26.30 | $56.23 | $56.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $10.72 Typical High $10.96 | Professional | 52 · Reduced service | $10.47 | $10.72 | $10.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.27 Typical High $4.37 | Professional | 53 · Discontinued | $4.17 | $4.27 | $4.37 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $3.24 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $3.24 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.14 Typical High $2.19 | Professional | 56 · Pre-op care only | $2.09 | $2.14 | $2.19 |
Where Texas sits
The same service costs 1.9 times more in Alaska than in Maryland. 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· 11th of 51
$24.55
AK $39.81MD $20.89
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.