How much rates vary
Facilitymedian $26 · 10th to 90th $7 to $44Professionalmedian $4 · 10th to 90th $3 to $62
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 $3.39 Median $40.74 Typical High $67.61 | Facility | None | $3.39 | $40.74 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $5.01 | Professional | None | $3.39 | $3.39 | $5.01 |
BCBS Texas Setting Facility Modifier None Typical Low $8.13 Median $18.20 Typical High $37.15 | Facility | None | $8.13 | $18.20 | $37.15 |
BCBS Texas Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | None | $3.80 | $3.80 | $3.80 |
Baylor Scott & White Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Christus Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $3.39 Median $7.94 Typical High $11.22 | Facility | None | $3.39 | $7.94 | $11.22 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Moda Health Setting Facility Modifier None Typical Low $8.71 Median $32.36 Typical High $91.20 | Facility | None | $8.71 | $32.36 | $91.20 |
Moda Health Setting Professional Modifier None Typical Low $3.39 Median $30.90 Typical High $32.36 | Professional | None | $3.39 | $30.90 | $32.36 |
Molina Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Providence Setting Facility Modifier None Typical Low $3.39 Median $5.01 Typical High $28.84 | Facility | None | $3.39 | $5.01 | $28.84 |
Providence Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
United Setting Professional Modifier None Typical Low $30.90 Median $33.11 Typical High $81.28 | Professional | None | $30.90 | $33.11 | $81.28 |
Wellpoint Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
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 $1.70 Median $24.55 Typical High $33.88 | Facility | 52 · Reduced service | $1.70 | $24.55 | $33.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.68 Median $9.77 Typical High $13.49 | Facility | 53 · Discontinued | $0.68 | $9.77 | $13.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.50 Median $7.41 Typical High $10.00 | Facility | 55 · Aftercare only | $0.50 | $7.41 | $10.00 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.34 Median $4.90 Typical High $6.76 | Facility | 56 · Pre-op care only | $0.34 | $4.90 | $6.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.70 Median $1.70 Typical High $1.86 | Professional | 52 · Reduced service | $1.70 | $1.70 | $1.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.68 Typical High $0.74 | Professional | 53 · Discontinued | $0.68 | $0.68 | $0.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.50 Median $0.51 Typical High $0.56 | Professional | 55 · Aftercare only | $0.50 | $0.51 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.34 Typical High $0.37 | Professional | 56 · Pre-op care only | $0.34 | $0.34 | $0.37 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $8.51 Median $13.80 Typical High $51.29 | Facility | JZ · No drug discarded | $8.51 | $13.80 | $51.29 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $15.49 Typical High $16.22 | Professional | 52 · Reduced service | $15.49 | $15.49 | $16.22 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.31 Typical High $6.46 | Professional | 53 · Discontinued | $6.17 | $6.31 | $6.46 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $4.79 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $4.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.24 |
Where Texas sits
The same service costs 9.1 times more in Rhode Island than in Florida. 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· 12th of 51
$21.38
RI $30.90FL $3.39
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.