How much rates vary
Facilitymedian $5 · 10th to 90th $2 to $11Professionalmedian $1 · 10th to 90th $1 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 $1.23 Median $1.95 Typical High $2.82 | Facility | None | $1.23 | $1.95 | $2.82 |
Aetna Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.35 | Professional | None | $1.23 | $1.23 | $1.35 |
BCBS Texas Setting Facility Modifier None Typical Low $1.74 Median $4.37 Typical High $7.41 | Facility | None | $1.74 | $4.37 | $7.41 |
BCBS Texas Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | None | $2.40 | $2.40 | $2.40 |
Christus Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Cigna Setting Facility Modifier None Typical Low $1.20 Median $2.29 Typical High $3.89 | Facility | None | $1.20 | $2.29 | $3.89 |
Cigna Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | None | $1.20 | $1.20 | $1.20 |
Moda Health Setting Facility Modifier None Typical Low $1.29 Median $2.69 Typical High $12.88 | Facility | None | $1.29 | $2.69 | $12.88 |
Moda Health Setting Professional Modifier None Typical Low $1.23 Median $1.29 Typical High $1.41 | Professional | None | $1.23 | $1.29 | $1.41 |
Molina Setting Professional Modifier None Typical Low $0.85 Median $0.91 Typical High $1.35 | Professional | None | $0.85 | $0.91 | $1.35 |
Providence Setting Facility Modifier None Typical Low $1.15 Median $1.48 Typical High $10.23 | Facility | None | $1.15 | $1.48 | $10.23 |
Providence Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | None | $1.20 | $1.20 | $1.20 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.29 Typical High $1.29 | Professional | None | $1.02 | $1.29 | $1.29 |
Wellpoint Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
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 $0.62 Median $1.02 Typical High $1.41 | Facility | 52 · Reduced service | $0.62 | $1.02 | $1.41 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.24 Median $0.41 Typical High $0.56 | Facility | 53 · Discontinued | $0.24 | $0.41 | $0.56 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.18 Median $0.31 Typical High $0.42 | Facility | 55 · Aftercare only | $0.18 | $0.31 | $0.42 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.20 Typical High $0.28 | Facility | 56 · Pre-op care only | $0.12 | $0.20 | $0.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.62 Median $0.62 Typical High $0.68 | Professional | 52 · Reduced service | $0.62 | $0.62 | $0.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.24 Median $0.25 Typical High $0.27 | Professional | 53 · Discontinued | $0.24 | $0.25 | $0.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.18 Median $0.18 Typical High $0.20 | Professional | 55 · Aftercare only | $0.18 | $0.18 | $0.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.12 | $0.12 | $0.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.65 Median $0.65 Typical High $0.68 | Professional | 52 · Reduced service | $0.65 | $0.65 | $0.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.26 Typical High $0.27 | Professional | 53 · Discontinued | $0.26 | $0.26 | $0.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.20 Typical High $0.20 | Professional | 55 · Aftercare only | $0.19 | $0.20 | $0.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.13 |
Where Texas sits
The same service costs 3.4 times more in Texas than in Oklahoma. 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
$3.72
TX $3.72OK $1.10
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.