How much rates vary
Facilitymedian $15 · 10th to 90th $2 to $19Professionalmedian $2 · 10th to 90th $2 to $6
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 $2.19 Median $2.24 Typical High $4.57 | Facility | None | $2.19 | $2.24 | $4.57 |
Aetna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $3.24 | Professional | None | $2.19 | $2.19 | $3.24 |
BCBS Texas Setting Facility Modifier None Typical Low $3.39 Median $16.60 Typical High $21.38 | Facility | None | $3.39 | $16.60 | $21.38 |
BCBS Texas Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Christus Setting Facility Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Facility | None | $15.49 | $15.49 | $15.49 |
Cigna Setting Facility Modifier None Typical Low $2.19 Median $4.07 Typical High $6.92 | Facility | None | $2.19 | $4.07 | $6.92 |
Cigna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Moda Health Setting Facility Modifier None Typical Low $2.75 Median $6.76 Typical High $20.42 | Facility | None | $2.75 | $6.76 | $20.42 |
Moda Health Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $3.39 | Professional | None | $2.19 | $2.19 | $3.39 |
Molina Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
Providence Setting Facility Modifier None Typical Low $2.19 Median $2.82 Typical High $18.62 | Facility | None | $2.19 | $2.82 | $18.62 |
Providence Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
United Setting Professional Modifier None Typical Low $1.74 Median $2.19 Typical High $2.19 | Professional | None | $1.74 | $2.19 | $2.19 |
Wellpoint Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
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 $1.10 Median $1.74 Typical High $2.40 | Facility | 52 · Reduced service | $1.10 | $1.74 | $2.40 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.44 Median $0.71 Typical High $0.95 | Facility | 53 · Discontinued | $0.44 | $0.71 | $0.95 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.33 Median $0.52 Typical High $0.72 | Facility | 55 · Aftercare only | $0.33 | $0.52 | $0.72 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.35 Typical High $0.48 | Facility | 56 · Pre-op care only | $0.22 | $0.35 | $0.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.10 Median $1.10 Typical High $1.20 | Professional | 52 · Reduced service | $1.10 | $1.10 | $1.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.44 Median $0.44 Typical High $0.48 | Professional | 53 · Discontinued | $0.44 | $0.44 | $0.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.33 Typical High $0.36 | Professional | 55 · Aftercare only | $0.33 | $0.33 | $0.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $0.24 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $0.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.10 Median $1.12 Typical High $1.15 | Professional | 52 · Reduced service | $1.10 | $1.12 | $1.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.44 Median $0.44 Typical High $0.45 | Professional | 53 · Discontinued | $0.44 | $0.44 | $0.45 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.33 Typical High $0.34 | Professional | 55 · Aftercare only | $0.33 | $0.33 | $0.34 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $0.23 |
Where Texas sits
The same service costs 2.7 times more in Wyoming than in Nevada. 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
$5.62
WY $5.89NV $2.19
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.