How much rates vary
Facilitymedian $8 · 10th to 90th $3 to $23Professionalmedian $2 · 10th to 90th $2 to $2
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 $1.58 Median $1.95 Typical High $3.39 | Facility | None | $1.58 | $1.95 | $3.39 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $1.62 Typical High $1.78 | Professional | None | $1.58 | $1.62 | $1.78 |
BCBS Setting Facility Modifier None Typical Low $3.24 Median $7.94 Typical High $15.49 | Facility | None | $3.24 | $7.94 | $15.49 |
BCBS Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
Christus Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
Cigna Setting Facility Modifier None Typical Low $1.58 Median $3.24 Typical High $5.13 | Facility | None | $1.58 | $3.24 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | None | $1.58 | $1.58 | $1.58 |
Moda Health Setting Facility Modifier None Typical Low $5.62 Median $9.55 Typical High $53.70 | Facility | None | $5.62 | $9.55 | $53.70 |
Moda Health Setting Professional Modifier None Typical Low $1.55 Median $1.58 Typical High $1.62 | Professional | None | $1.55 | $1.58 | $1.62 |
Molina Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
Providence Setting Facility Modifier None Typical Low $1.58 Median $2.29 Typical High $13.80 | Facility | None | $1.58 | $2.29 | $13.80 |
Providence Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | None | $1.58 | $1.58 | $1.58 |
United Setting Professional Modifier None Typical Low $1.55 Median $1.55 Typical High $1.55 | Professional | None | $1.55 | $1.55 | $1.55 |
Wellpoint Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
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 $0.79 Median $1.23 Typical High $1.70 | Facility | 52 · Reduced service | $0.79 | $1.23 | $1.70 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.32 Median $0.50 Typical High $0.68 | Facility | 53 · Discontinued | $0.32 | $0.50 | $0.68 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.24 Median $0.37 Typical High $0.51 | Facility | 55 · Aftercare only | $0.24 | $0.37 | $0.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.24 Typical High $0.34 | Facility | 56 · Pre-op care only | $0.16 | $0.24 | $0.34 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.79 Median $0.81 Typical High $0.87 | Professional | 52 · Reduced service | $0.79 | $0.81 | $0.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.32 Typical High $0.35 | Professional | 53 · Discontinued | $0.32 | $0.32 | $0.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.24 Typical High $0.26 | Professional | 55 · Aftercare only | $0.24 | $0.24 | $0.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.78 Median $0.79 Typical High $0.81 | Professional | 52 · Reduced service | $0.78 | $0.79 | $0.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.31 Median $0.31 Typical High $0.32 | Professional | 53 · Discontinued | $0.31 | $0.31 | $0.32 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.23 Median $0.24 Typical High $0.24 | Professional | 55 · Aftercare only | $0.23 | $0.24 | $0.24 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.16 |
Where Texas sits
The same service costs 3.6 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
$5.62
TX $5.62RI $1.55
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.