How much rates vary
Facilitymedian $8 · 10th to 90th $3 to $17Professionalmedian $3 · 10th to 90th $3 to $6
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 $3.02 Median $5.25 Typical High $7.08 | Facility | None | $3.02 | $5.25 | $7.08 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $1.51 Median $2.63 Typical High $3.55 | Facility | 52 · Reduced service | $1.51 | $2.63 | $3.55 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.62 Median $1.05 Typical High $1.45 | Facility | 53 · Discontinued | $0.62 | $1.05 | $1.45 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.46 Median $0.78 Typical High $1.07 | Facility | 55 · Aftercare only | $0.46 | $0.78 | $1.07 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.09 Typical High $3.39 | Professional | None | $3.02 | $3.09 | $3.39 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.51 Median $1.55 Typical High $1.66 | Professional | 52 · Reduced service | $1.51 | $1.55 | $1.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.62 Typical High $0.68 | Professional | 53 · Discontinued | $0.62 | $0.62 | $0.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.46 Median $0.46 Typical High $0.50 | Professional | 55 · Aftercare only | $0.46 | $0.46 | $0.50 |
BCBS Texas Setting Facility Modifier None Typical Low $5.25 Median $9.77 Typical High $17.78 | Facility | None | $5.25 | $9.77 | $17.78 |
BCBS Texas Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $5.89 Typical High $9.77 | Facility | None | $3.02 | $5.89 | $9.77 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
Moda Health Setting Facility Modifier None Typical Low $3.24 Median $4.27 Typical High $7.94 | Facility | None | $3.24 | $4.27 | $7.94 |
Moda Health Setting Professional Modifier None Typical Low $3.24 Median $3.31 Typical High $3.63 | Professional | None | $3.24 | $3.31 | $3.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.62 Median $1.66 Typical High $1.70 | Professional | 52 · Reduced service | $1.62 | $1.66 | $1.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.66 Typical High $0.68 | Professional | 53 · Discontinued | $0.65 | $0.66 | $0.68 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.50 Typical High $0.51 | Professional | 55 · Aftercare only | $0.49 | $0.50 | $0.51 |
Molina Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Providence Setting Facility Modifier None Typical Low $3.02 Median $4.37 Typical High $25.70 | Facility | None | $3.02 | $4.37 | $25.70 |
Providence Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
United Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Facility | None | $3.02 | $3.02 | $3.02 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Wellpoint Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | None | $3.63 | $3.63 | $3.63 |
3 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 56 · Pre-op care only Typical Low $0.30 Median $0.52 Typical High $0.71 | Facility | 56 · Pre-op care only | $0.30 | $0.52 | $0.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.31 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.30 | $0.31 | $0.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.33 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.33 | $0.33 | $0.34 |
Where Texas sits
The same service costs 6.0 times more in Wyoming than in Georgia. 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· 4th of 51
$5.75
WY $18.20GA $3.02
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.