How much rates vary
Facilitymedian $72 · 10th to 90th $30 to $141Professionalmedian $30 · 10th to 90th $29 to $34
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 $30.20 Median $47.86 Typical High $66.07 | Facility | None | $30.20 | $47.86 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $33.88 | Professional | None | $30.20 | $30.20 | $33.88 |
BCBS Texas Setting Facility Modifier None Typical Low $30.90 Median $75.86 Typical High $144.54 | Facility | None | $30.90 | $75.86 | $144.54 |
BCBS Texas Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $43.65 Typical High $91.20 | Facility | None | $28.84 | $43.65 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Moda Health Setting Facility Modifier None Typical Low $30.20 Median $37.15 Typical High $63.10 | Facility | None | $30.20 | $37.15 | $63.10 |
Moda Health Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Providence Setting Facility Modifier None Typical Low $28.84 Median $40.74 Typical High $245.47 | Facility | None | $28.84 | $40.74 | $245.47 |
Providence Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
United Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Wellpoint Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
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 $15.14 Median $23.99 Typical High $33.11 | Facility | 52 · Reduced service | $15.14 | $23.99 | $33.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.03 Median $9.55 Typical High $13.18 | Facility | 53 · Discontinued | $6.03 | $9.55 | $13.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.47 Median $7.24 Typical High $9.77 | Facility | 55 · Aftercare only | $4.47 | $7.24 | $9.77 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.02 Median $4.79 Typical High $6.61 | Facility | 56 · Pre-op care only | $3.02 | $4.79 | $6.61 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.14 Median $15.14 Typical High $16.98 | Professional | 52 · Reduced service | $15.14 | $15.14 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $6.76 | Professional | 53 · Discontinued | $6.03 | $6.03 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.57 Typical High $5.13 | Professional | 55 · Aftercare only | $4.47 | $4.57 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $3.39 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $3.39 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 52 · Reduced service | $15.14 | $15.14 | $15.14 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 53 · Discontinued | $6.03 | $6.03 | $6.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.57 Typical High $4.57 | Professional | 55 · Aftercare only | $4.47 | $4.57 | $4.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $3.02 |
Where Texas sits
The same service costs 1.7 times more in Arizona than in Oklahoma. 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
$44.67
AZ $48.98OK $28.18
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.