How much rates vary
Facilitymedian $19 · 10th to 90th $14 to $58Professionalmedian $18 · 10th to 90th $18 to $18
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 $18.20 Median $28.84 Typical High $39.81 | Facility | None | $18.20 | $28.84 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $19.95 | Professional | None | $18.20 | $18.20 | $19.95 |
BCBS Setting Facility Modifier None Typical Low $15.49 Median $34.67 Typical High $75.86 | Facility | None | $15.49 | $34.67 | $75.86 |
BCBS Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Christus Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
Cigna Setting Facility Modifier None Typical Low $18.20 Median $33.88 Typical High $57.54 | Facility | None | $18.20 | $33.88 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Moda Health Setting Facility Modifier None Typical Low $18.20 Median $25.12 Typical High $43.65 | Facility | None | $18.20 | $25.12 | $43.65 |
Moda Health Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $19.05 | Professional | None | $18.20 | $18.20 | $19.05 |
Molina Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Providence Setting Facility Modifier None Typical Low $18.20 Median $25.70 Typical High $154.88 | Facility | None | $18.20 | $25.70 | $154.88 |
Providence Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
United Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
United Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Wellpoint Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
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 $9.12 Median $14.45 Typical High $19.95 | Facility | 52 · Reduced service | $9.12 | $14.45 | $19.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.63 Median $5.75 Typical High $7.94 | Facility | 53 · Discontinued | $3.63 | $5.75 | $7.94 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.69 Median $4.37 Typical High $5.89 | Facility | 55 · Aftercare only | $2.69 | $4.37 | $5.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.82 Median $2.88 Typical High $3.98 | Facility | 56 · Pre-op care only | $1.82 | $2.88 | $3.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.12 Median $9.12 Typical High $10.00 | Professional | 52 · Reduced service | $9.12 | $9.12 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $3.98 | Professional | 53 · Discontinued | $3.63 | $3.63 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.75 Typical High $3.02 | Professional | 55 · Aftercare only | $2.69 | $2.75 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $2.00 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $2.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $9.12 Median $9.12 Typical High $9.33 | Professional | 52 · Reduced service | $9.12 | $9.12 | $9.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $3.80 | Professional | 53 · Discontinued | $3.63 | $3.63 | $3.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.75 Typical High $2.82 | Professional | 55 · Aftercare only | $2.69 | $2.75 | $2.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $1.91 |
Where Texas sits
The same service costs 28.8 times more in Alabama than in Washington, DC. 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· 27th of 51
$18.20
AL $525DC $18.20
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.