How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $5Professionalmedian $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 $0.58 Median $1.10 Typical High $1.48 | Facility | None | $0.58 | $1.10 | $1.48 |
Aetna Setting Professional Modifier None Typical Low $0.58 Median $0.59 Typical High $0.65 | Professional | None | $0.58 | $0.59 | $0.65 |
BCBS Texas Setting Facility Modifier None Typical Low $1.05 Median $2.69 Typical High $5.01 | Facility | None | $1.05 | $2.69 | $5.01 |
BCBS Texas Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | None | $0.62 | $0.62 | $0.62 |
Cigna Setting Facility Modifier None Typical Low $0.58 Median $1.35 Typical High $1.95 | Facility | None | $0.58 | $1.35 | $1.95 |
Cigna Setting Professional Modifier None Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | None | $0.58 | $0.58 | $0.58 |
Moda Health Setting Facility Modifier None Typical Low $0.68 Median $0.89 Typical High $1.66 | Facility | None | $0.68 | $0.89 | $1.66 |
Moda Health Setting Professional Modifier None Typical Low $0.58 Median $0.69 Typical High $0.91 | Professional | None | $0.58 | $0.69 | $0.91 |
Molina Setting Professional Modifier None Typical Low $0.59 Median $0.59 Typical High $0.68 | Professional | None | $0.59 | $0.59 | $0.68 |
Providence Setting Facility Modifier None Typical Low $0.58 Median $0.83 Typical High $5.01 | Facility | None | $0.58 | $0.83 | $5.01 |
Providence Setting Professional Modifier None Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | None | $0.58 | $0.58 | $0.58 |
United Setting Facility Modifier None Typical Low $0.58 Median $0.58 Typical High $0.58 | Facility | None | $0.58 | $0.58 | $0.58 |
United Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | None | $0.68 | $0.68 | $0.68 |
Wellpoint Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | None | $0.68 | $0.68 | $0.68 |
15 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 $0.28 Median $0.55 Typical High $0.76 | Facility | 52 · Reduced service | $0.28 | $0.55 | $0.76 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.12 Median $0.22 Typical High $0.30 | Facility | 53 · Discontinued | $0.12 | $0.22 | $0.30 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $0.44 Median $0.81 Typical High $1.12 | Facility | 54 · Surgery only | $0.44 | $0.81 | $1.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.09 Median $0.16 Typical High $0.22 | Facility | 55 · Aftercare only | $0.09 | $0.16 | $0.22 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.10 Typical High $0.15 | Facility | 56 · Pre-op care only | $0.06 | $0.10 | $0.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.28 Median $0.30 Typical High $0.32 | Professional | 52 · Reduced service | $0.28 | $0.30 | $0.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.12 Typical High $0.13 | Professional | 53 · Discontinued | $0.12 | $0.12 | $0.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $0.44 Median $0.44 Typical High $0.48 | Professional | 54 · Surgery only | $0.44 | $0.44 | $0.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.10 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.34 Median $0.35 Typical High $0.36 | Professional | 52 · Reduced service | $0.34 | $0.35 | $0.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 53 · Discontinued | $0.14 | $0.14 | $0.14 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $0.51 Median $0.52 Typical High $0.52 | Professional | 54 · Surgery only | $0.51 | $0.52 | $0.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.10 Typical High $0.11 | Professional | 55 · Aftercare only | $0.10 | $0.10 | $0.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.07 |
Where Texas sits
The same service costs 4.1 times more in Wyoming than in Delaware. 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· 3rd of 51
$1.20
WY $2.34DE $0.58
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.