How much rates vary
Facilitymedian $6 · 10th to 90th $2 to $11Professionalmedian $2 · 10th to 90th $2 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 $2.29 Median $3.55 Typical High $4.90 | Facility | None | $2.29 | $3.55 | $4.90 |
Aetna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.51 | Professional | None | $2.29 | $2.29 | $2.51 |
BCBS Texas Setting Facility Modifier None Typical Low $2.40 Median $6.03 Typical High $11.22 | Facility | None | $2.40 | $6.03 | $11.22 |
BCBS Texas Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Cigna Setting Facility Modifier None Typical Low $2.29 Median $4.37 Typical High $7.41 | Facility | None | $2.29 | $4.37 | $7.41 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
Moda Health Setting Facility Modifier None Typical Low $2.24 Median $2.95 Typical High $5.37 | Facility | None | $2.24 | $2.95 | $5.37 |
Moda Health Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.45 | Professional | None | $2.24 | $2.24 | $2.45 |
Molina Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Providence Setting Facility Modifier None Typical Low $2.29 Median $3.31 Typical High $19.50 | Facility | None | $2.29 | $3.31 | $19.50 |
Providence Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
United Setting Facility Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Facility | None | $2.29 | $2.29 | $2.29 |
United Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Wellpoint Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
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 $1.15 Median $1.78 Typical High $2.45 | Facility | 52 · Reduced service | $1.15 | $1.78 | $2.45 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.46 Median $0.71 Typical High $0.98 | Facility | 53 · Discontinued | $0.46 | $0.71 | $0.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.35 Median $0.52 Typical High $0.72 | Facility | 55 · Aftercare only | $0.35 | $0.52 | $0.72 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.36 Typical High $0.49 | Facility | 56 · Pre-op care only | $0.23 | $0.36 | $0.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.15 Median $1.15 Typical High $1.26 | Professional | 52 · Reduced service | $1.15 | $1.15 | $1.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.46 Median $0.46 Typical High $0.51 | Professional | 53 · Discontinued | $0.46 | $0.46 | $0.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.35 Median $0.35 Typical High $0.38 | Professional | 55 · Aftercare only | $0.35 | $0.35 | $0.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.23 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.23 | $0.23 | $0.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.12 Median $1.12 Typical High $1.15 | Professional | 52 · Reduced service | $1.12 | $1.12 | $1.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.45 Median $0.45 Typical High $0.46 | Professional | 53 · Discontinued | $0.45 | $0.45 | $0.46 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.34 Typical High $0.35 | Professional | 55 · Aftercare only | $0.33 | $0.34 | $0.35 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.23 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.22 | $0.23 | $0.23 |
Where Texas sits
The same service costs 1.9 times more in Alaska than in Rhode Island. 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
$3.72
AK $4.17RI $2.24
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.