How much rates vary
Facilitymedian $22 · 10th to 90th $10 to $43Professionalmedian $15 · 10th to 90th $13 to $22
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 $12.88 Median $22.39 Typical High $32.36 | Facility | None | $12.88 | $22.39 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $13.18 Typical High $14.45 | Professional | None | $12.88 | $13.18 | $14.45 |
BCBS Texas Setting Facility Modifier None Typical Low $9.55 Median $22.91 Typical High $40.74 | Facility | None | $9.55 | $22.91 | $40.74 |
BCBS Texas Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Cigna Setting Facility Modifier None Typical Low $12.88 Median $24.55 Typical High $41.69 | Facility | None | $12.88 | $24.55 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
Moda Health Setting Facility Modifier None Typical Low $11.75 Median $21.38 Typical High $44.67 | Facility | None | $11.75 | $21.38 | $44.67 |
Moda Health Setting Professional Modifier None Typical Low $14.79 Median $15.14 Typical High $16.22 | Professional | None | $14.79 | $15.14 | $16.22 |
Molina Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
Providence Setting Facility Modifier None Typical Low $9.55 Median $15.49 Typical High $109.65 | Facility | None | $9.55 | $15.49 | $109.65 |
Providence Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
United Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Wellpoint Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | None | $15.49 | $15.49 | $15.49 |
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 $6.46 Median $11.75 Typical High $16.22 | Facility | 52 · Reduced service | $6.46 | $11.75 | $16.22 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.57 Median $4.79 Typical High $6.46 | Facility | 53 · Discontinued | $2.57 | $4.79 | $6.46 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.95 Median $3.55 Typical High $4.90 | Facility | 55 · Aftercare only | $1.95 | $3.55 | $4.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.29 Median $2.40 Typical High $3.24 | Facility | 56 · Pre-op care only | $1.29 | $2.40 | $3.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.46 Median $6.61 Typical High $7.08 | Professional | 52 · Reduced service | $6.46 | $6.61 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.63 Typical High $2.82 | Professional | 53 · Discontinued | $2.57 | $2.63 | $2.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $1.95 Typical High $2.14 | Professional | 55 · Aftercare only | $1.95 | $1.95 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.32 Typical High $1.41 | Professional | 56 · Pre-op care only | $1.29 | $1.32 | $1.41 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.41 Median $7.59 Typical High $7.76 | Professional | 52 · Reduced service | $7.41 | $7.59 | $7.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $3.02 Typical High $3.09 | Professional | 53 · Discontinued | $2.95 | $3.02 | $3.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.24 Typical High $2.34 | Professional | 55 · Aftercare only | $2.24 | $2.24 | $2.34 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $1.51 Typical High $1.55 | Professional | 56 · Pre-op care only | $1.48 | $1.51 | $1.55 |
Where Texas sits
The same service costs 2.0 times more in South Carolina than in Kentucky. 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· 4th of 51
$19.95
SC $25.70KY $12.88
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.