How much rates vary
Facilitymedian $5 · 10th to 90th $1 to $11Professionalmedian $1 · 10th to 90th $1 to $10
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 $1.35 Median $1.51 Typical High $2.82 | Facility | None | $1.35 | $1.51 | $2.82 |
Aetna Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.48 | Professional | None | $1.35 | $1.35 | $1.48 |
BCBS Texas Setting Facility Modifier None Typical Low $1.70 Median $8.91 Typical High $12.02 | Facility | None | $1.70 | $8.91 | $12.02 |
BCBS Texas Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
Baylor Scott & White Setting Facility Modifier None Typical Low $1.32 Median $1.35 Typical High $1.35 | Facility | None | $1.32 | $1.35 | $1.35 |
Cigna Setting Facility Modifier None Typical Low $1.35 Median $2.51 Typical High $4.27 | Facility | None | $1.35 | $2.51 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | None | $1.35 | $1.35 | $1.35 |
Moda Health Setting Facility Modifier None Typical Low $1.35 Median $4.79 Typical High $10.23 | Facility | None | $1.35 | $4.79 | $10.23 |
Moda Health Setting Professional Modifier None Typical Low $1.35 Median $1.38 Typical High $2.00 | Professional | None | $1.35 | $1.38 | $2.00 |
Molina Setting Professional Modifier None Typical Low $0.89 Median $0.95 Typical High $1.38 | Professional | None | $0.89 | $0.95 | $1.38 |
Providence Setting Facility Modifier None Typical Low $1.35 Median $1.62 Typical High $11.48 | Facility | None | $1.35 | $1.62 | $11.48 |
Providence Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | None | $1.35 | $1.35 | $1.35 |
United Setting Professional Modifier None Typical Low $1.10 Median $1.35 Typical High $1.35 | Professional | None | $1.10 | $1.35 | $1.35 |
Wellpoint Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
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 $0.68 Median $1.07 Typical High $1.48 | Facility | 52 · Reduced service | $0.68 | $1.07 | $1.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.27 Median $0.43 Typical High $0.59 | Facility | 53 · Discontinued | $0.27 | $0.43 | $0.59 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.20 Median $0.32 Typical High $0.44 | Facility | 55 · Aftercare only | $0.20 | $0.32 | $0.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.21 Typical High $0.30 | Facility | 56 · Pre-op care only | $0.14 | $0.21 | $0.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.68 Median $0.68 Typical High $0.76 | Professional | 52 · Reduced service | $0.68 | $0.68 | $0.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.27 Typical High $0.30 | Professional | 53 · Discontinued | $0.27 | $0.27 | $0.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $0.22 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $0.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.68 Median $0.69 Typical High $0.71 | Professional | 52 · Reduced service | $0.68 | $0.69 | $0.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.27 Typical High $0.28 | Professional | 53 · Discontinued | $0.27 | $0.27 | $0.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.21 Typical High $0.21 | Professional | 55 · Aftercare only | $0.20 | $0.21 | $0.21 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.14 |
Where Texas sits
The same service costs 3.2 times more in Wyoming than in Maine. 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· 5th of 51
$1.91
WY $4.27ME $1.35
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.