How much rates vary
Facilitymedian $107 · 10th to 90th $49 to $204Professionalmedian $55 · 10th to 90th $35 to $58
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 $56.23 Median $87.10 Typical High $120.23 | Facility | None | $56.23 | $87.10 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $57.54 Typical High $58.88 | Professional | None | $56.23 | $57.54 | $58.88 |
BCBS Texas Setting Facility Modifier None Typical Low $44.67 Median $112.20 Typical High $208.93 | Facility | None | $44.67 | $112.20 | $208.93 |
BCBS Texas Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $107.15 Typical High $181.97 | Facility | None | $56.23 | $107.15 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Moda Health Setting Facility Modifier None Typical Low $27.54 Median $72.44 Typical High $134.90 | Facility | None | $27.54 | $72.44 | $134.90 |
Moda Health Setting Professional Modifier None Typical Low $54.95 Median $56.23 Typical High $57.54 | Professional | None | $54.95 | $56.23 | $57.54 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Providence Setting Facility Modifier None Typical Low $51.29 Median $69.18 Typical High $489.78 | Facility | None | $51.29 | $69.18 | $489.78 |
Providence Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $58.88 | Professional | None | $56.23 | $56.23 | $58.88 |
United Setting Professional Modifier None Typical Low $21.88 Median $54.95 Typical High $54.95 | Professional | None | $21.88 | $54.95 | $54.95 |
Wellpoint Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $56.23 | Professional | None | $54.95 | $54.95 | $56.23 |
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 $28.18 Median $43.65 Typical High $60.26 | Facility | 52 · Reduced service | $28.18 | $43.65 | $60.26 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.48 Median $17.78 Typical High $23.99 | Facility | 53 · Discontinued | $11.48 | $17.78 | $23.99 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.51 Median $13.18 Typical High $18.20 | Facility | 55 · Aftercare only | $8.51 | $13.18 | $18.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.62 Median $8.71 Typical High $12.02 | Facility | 56 · Pre-op care only | $5.62 | $8.71 | $12.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $28.84 Typical High $29.51 | Professional | 52 · Reduced service | $28.18 | $28.84 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $11.75 | Professional | 53 · Discontinued | $11.48 | $11.48 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.71 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.75 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.62 | $5.75 | $5.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $27.54 Typical High $28.84 | Professional | 52 · Reduced service | $27.54 | $27.54 | $28.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $11.22 Typical High $11.48 | Professional | 53 · Discontinued | $10.96 | $11.22 | $11.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $8.71 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $8.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.62 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.50 | $5.62 | $5.75 |
Where Texas sits
The same service costs 1.6 times more in Alaska than in Louisiana. 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
$56.23
AK $83.18LA $52.48
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.