How much rates vary
Facilitymedian $4 · 10th to 90th $2 to $8Professionalmedian $3 · 10th to 90th $2 to $3
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 $2.57 Median $3.89 Typical High $5.37 | Facility | None | $2.57 | $3.89 | $5.37 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $1.29 Median $1.95 Typical High $2.69 | Facility | 52 · Reduced service | $1.29 | $1.95 | $2.69 |
Aetna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.82 | Professional | None | $2.57 | $2.57 | $2.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.29 Median $1.29 Typical High $1.41 | Professional | 52 · Reduced service | $1.29 | $1.29 | $1.41 |
BCBS Texas Setting Facility Modifier None Typical Low $2.00 Median $4.57 Typical High $7.76 | Facility | None | $2.00 | $4.57 | $7.76 |
Cigna Setting Facility Modifier None Typical Low $2.57 Median $4.90 Typical High $8.32 | Facility | None | $2.57 | $4.90 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Moda Health Setting Facility Modifier None Typical Low $2.45 Median $3.47 Typical High $6.03 | Facility | None | $2.45 | $3.47 | $6.03 |
Moda Health Setting Professional Modifier None Typical Low $2.45 Median $2.51 Typical High $2.69 | Professional | None | $2.45 | $2.51 | $2.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.23 Median $1.26 Typical High $1.29 | Professional | 52 · Reduced service | $1.23 | $1.26 | $1.29 |
Molina Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | None | $2.40 | $2.40 | $2.40 |
Providence Setting Facility Modifier None Typical Low $2.45 Median $3.63 Typical High $21.88 | Facility | None | $2.45 | $3.63 | $21.88 |
Providence Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
United Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Facility | None | $2.57 | $2.57 | $2.57 |
United Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | None | $2.45 | $2.45 | $2.45 |
Wellpoint Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | None | $2.45 | $2.45 | $2.45 |
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 53 · Discontinued Typical Low $0.52 Median $0.79 Typical High $1.07 | Facility | 53 · Discontinued | $0.52 | $0.79 | $1.07 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $1.95 Median $2.95 Typical High $4.07 | Facility | 54 · Surgery only | $1.95 | $2.95 | $4.07 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.39 Median $0.59 Typical High $0.81 | Facility | 55 · Aftercare only | $0.39 | $0.59 | $0.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.39 Typical High $0.54 | Facility | 56 · Pre-op care only | $0.26 | $0.39 | $0.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $0.52 Typical High $0.56 | Professional | 53 · Discontinued | $0.52 | $0.52 | $0.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.95 Median $1.95 Typical High $2.14 | Professional | 54 · Surgery only | $1.95 | $1.95 | $2.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.39 Median $0.39 Typical High $0.43 | Professional | 55 · Aftercare only | $0.39 | $0.39 | $0.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.26 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.26 | $0.26 | $0.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.49 Median $0.50 Typical High $0.51 | Professional | 53 · Discontinued | $0.49 | $0.50 | $0.51 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1.86 Median $1.86 Typical High $1.91 | Professional | 54 · Surgery only | $1.86 | $1.86 | $1.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $0.37 Typical High $0.38 | Professional | 55 · Aftercare only | $0.37 | $0.37 | $0.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.25 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.25 | $0.25 | $0.26 |
Where Texas sits
The same service costs 1.8 times more in Alaska than in Maryland. 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· 16th of 51
$2.69
AK $4.47MD $2.45
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.