How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $4Professionalmedian $1 · 10th to 90th $1 to $1
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 $1.26 Median $2.24 Typical High $3.02 | Facility | None | $1.26 | $2.24 | $3.02 |
Aetna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.38 | Professional | None | $1.26 | $1.26 | $1.38 |
BCBS Texas Setting Facility Modifier None Typical Low $0.76 Median $1.91 Typical High $3.63 | Facility | None | $0.76 | $1.91 | $3.63 |
BCBS Texas Setting Professional Modifier None Typical Low $0.78 Median $0.78 Typical High $1.58 | Professional | None | $0.78 | $0.78 | $1.58 |
Cigna Setting Facility Modifier None Typical Low $1.26 Median $2.34 Typical High $3.98 | Facility | None | $1.26 | $2.34 | $3.98 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Moda Health Setting Facility Modifier None Typical Low $1.05 Median $1.51 Typical High $2.88 | Facility | None | $1.05 | $1.51 | $2.88 |
Moda Health Setting Professional Modifier None Typical Low $1.38 Median $1.41 Typical High $1.51 | Professional | None | $1.38 | $1.41 | $1.51 |
Molina Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Providence Setting Facility Modifier None Typical Low $1.23 Median $1.51 Typical High $10.72 | Facility | None | $1.23 | $1.51 | $10.72 |
Providence Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
United Setting Facility Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Facility | None | $1.26 | $1.26 | $1.26 |
United Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
Wellpoint Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
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 $0.63 Median $1.12 Typical High $1.51 | Facility | 52 · Reduced service | $0.63 | $1.12 | $1.51 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.25 Median $0.45 Typical High $0.62 | Facility | 53 · Discontinued | $0.25 | $0.45 | $0.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.19 Median $0.33 Typical High $0.46 | Facility | 55 · Aftercare only | $0.19 | $0.33 | $0.46 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.21 Typical High $0.30 | Facility | 56 · Pre-op care only | $0.13 | $0.21 | $0.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.63 Median $0.63 Typical High $0.69 | Professional | 52 · Reduced service | $0.63 | $0.63 | $0.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.25 Median $0.25 Typical High $0.27 | Professional | 53 · Discontinued | $0.25 | $0.25 | $0.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.19 Typical High $0.21 | Professional | 55 · Aftercare only | $0.19 | $0.19 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.71 Median $0.71 Typical High $0.72 | Professional | 52 · Reduced service | $0.71 | $0.71 | $0.72 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $0.29 | Professional | 53 · Discontinued | $0.28 | $0.28 | $0.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.22 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.22 |
Moda Health 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 |
Where Texas sits
The same service costs 1.7 times more in Arizona 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· 7th of 51
$1.51
AZ $2.14OK $1.26
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.