How much rates vary
Facilitymedian $9 · 10th to 90th $2 to $19Professionalmedian $2 · 10th to 90th $2 to $9
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 $1.66 Median $2.45 Typical High $4.07 | Facility | None | $1.66 | $2.45 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $1.95 | Professional | None | $1.66 | $1.66 | $1.95 |
BCBS Texas Setting Facility Modifier None Typical Low $7.59 Median $12.02 Typical High $19.50 | Facility | None | $7.59 | $12.02 | $19.50 |
BCBS Texas Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $1.66 Median $3.09 Typical High $5.25 | Facility | None | $1.66 | $3.09 | $5.25 |
Cigna Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | None | $1.66 | $1.66 | $1.66 |
Moda Health Setting Facility Modifier None Typical Low $1.86 Median $12.30 Typical High $18.62 | Facility | None | $1.86 | $12.30 | $18.62 |
Moda Health Setting Professional Modifier None Typical Low $1.66 Median $1.91 Typical High $2.40 | Professional | None | $1.66 | $1.91 | $2.40 |
Molina Setting Professional Modifier None Typical Low $1.15 Median $1.32 Typical High $2.04 | Professional | None | $1.15 | $1.32 | $2.04 |
Providence Setting Facility Modifier None Typical Low $1.66 Median $2.34 Typical High $14.13 | Facility | None | $1.66 | $2.34 | $14.13 |
Providence Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | None | $1.66 | $1.66 | $1.66 |
United Setting Professional Modifier None Typical Low $1.51 Median $1.86 Typical High $1.86 | Professional | None | $1.51 | $1.86 | $1.86 |
Wellpoint Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
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 $0.83 Median $1.48 Typical High $2.04 | Facility | 52 · Reduced service | $0.83 | $1.48 | $2.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.33 Median $0.60 Typical High $0.81 | Facility | 53 · Discontinued | $0.33 | $0.60 | $0.81 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.25 Median $0.45 Typical High $0.62 | Facility | 55 · Aftercare only | $0.25 | $0.45 | $0.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.30 Typical High $0.41 | Facility | 56 · Pre-op care only | $0.17 | $0.30 | $0.41 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.83 Median $0.83 Typical High $0.91 | Professional | 52 · Reduced service | $0.83 | $0.83 | $0.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.33 Median $0.33 Typical High $0.36 | Professional | 53 · Discontinued | $0.33 | $0.33 | $0.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.25 Median $0.25 Typical High $0.27 | Professional | 55 · Aftercare only | $0.25 | $0.25 | $0.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.17 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.17 | $0.17 | $0.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.93 Median $0.95 Typical High $0.98 | Professional | 52 · Reduced service | $0.93 | $0.95 | $0.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.37 Median $0.38 Typical High $0.39 | Professional | 53 · Discontinued | $0.37 | $0.38 | $0.39 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $0.29 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $0.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.19 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.19 | $0.19 | $0.20 |
Where Texas sits
The same service costs 3.2 times more in Texas than in Georgia. 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
$5.25
TX $5.25GA $1.66
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.