How much rates vary
Facilitymedian $39 · 10th to 90th $12 to $100Professionalmedian $8 · 10th to 90th $7 to $13
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 $10.23 Median $12.30 Typical High $16.98 | Facility | None | $10.23 | $12.30 | $16.98 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $5.13 Median $6.17 Typical High $8.51 | Facility | 52 · Reduced service | $5.13 | $6.17 | $8.51 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.04 Median $2.51 Typical High $3.39 | Facility | 53 · Discontinued | $2.04 | $2.51 | $3.39 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.51 Median $1.86 Typical High $2.51 | Facility | 55 · Aftercare only | $1.51 | $1.86 | $2.51 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $12.30 Typical High $12.59 | Professional | None | $8.13 | $12.30 | $12.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.07 Median $6.17 Typical High $6.31 | Professional | 52 · Reduced service | $4.07 | $6.17 | $6.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $2.45 Typical High $2.51 | Professional | 53 · Discontinued | $1.62 | $2.45 | $2.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.86 Typical High $1.91 | Professional | 55 · Aftercare only | $1.23 | $1.86 | $1.91 |
BCBS Texas Setting Facility Modifier None Typical Low $22.39 Median $60.26 Typical High $114.82 | Facility | None | $22.39 | $60.26 | $114.82 |
BCBS Texas Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
Cigna Setting Facility Modifier None Typical Low $12.30 Median $28.84 Typical High $40.74 | Facility | None | $12.30 | $28.84 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $48.98 | Professional | None | $12.30 | $12.30 | $48.98 |
Moda Health Setting Facility Modifier None Typical Low $7.76 Median $11.48 Typical High $75.86 | Facility | None | $7.76 | $11.48 | $75.86 |
Moda Health Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $12.30 | Professional | None | $7.76 | $7.76 | $12.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.89 Median $3.89 Typical High $4.07 | Professional | 52 · Reduced service | $3.89 | $3.89 | $4.07 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.55 Median $1.58 Typical High $1.62 | Professional | 53 · Discontinued | $1.55 | $1.58 | $1.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.17 Median $1.17 Typical High $1.23 | Professional | 55 · Aftercare only | $1.17 | $1.17 | $1.23 |
Molina Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Providence Setting Facility Modifier None Typical Low $12.30 Median $17.78 Typical High $104.71 | Facility | None | $12.30 | $17.78 | $104.71 |
Providence Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $48.98 | Professional | None | $12.30 | $12.30 | $48.98 |
United Setting Professional Modifier None Typical Low $3.09 Median $7.76 Typical High $7.76 | Professional | None | $3.09 | $7.76 | $7.76 |
Wellpoint Setting Professional Modifier None Typical Low $12.30 Median $12.59 Typical High $12.59 | Professional | None | $12.30 | $12.59 | $12.59 |
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 $1.02 Median $1.23 Typical High $1.70 | Facility | 56 · Pre-op care only | $1.02 | $1.23 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $1.23 Typical High $1.26 | Professional | 56 · Pre-op care only | $0.81 | $1.23 | $1.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $0.78 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.78 | $0.78 | $0.81 |
Where Texas sits
The same service costs 6.3 times more in Wyoming than in Rhode Island. 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· 46th of 51
$10.96
WY $48.98RI $7.76
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.