How much rates vary
Facilitymedian $43 · 10th to 90th $16 to $85Professionalmedian $14 · 10th to 90th $11 to $93
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 $11.48 Median $18.20 Typical High $30.20 | Facility | None | $11.48 | $18.20 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $12.02 | Professional | None | $11.48 | $11.48 | $12.02 |
Ambetter Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
BCBS Texas Setting Facility Modifier None Typical Low $22.39 Median $48.98 Typical High $91.20 | Facility | None | $22.39 | $48.98 | $91.20 |
BCBS Texas Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Cigna Setting Facility Modifier None Typical Low $11.48 Median $22.39 Typical High $37.15 | Facility | None | $11.48 | $22.39 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Lucent Health Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Moda Health Setting Facility Modifier None Typical Low $13.80 Median $16.98 Typical High $28.84 | Facility | None | $13.80 | $16.98 | $28.84 |
Moda Health Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $14.45 | Professional | None | $13.80 | $13.80 | $14.45 |
Molina Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $13.80 | Professional | None | $12.02 | $12.02 | $13.80 |
Oscar Health Setting Professional Modifier None Typical Low $14.79 Median $24.55 Typical High $51.29 | Professional | None | $14.79 | $24.55 | $51.29 |
Providence Setting Facility Modifier None Typical Low $11.48 Median $16.60 Typical High $100.00 | Facility | None | $11.48 | $16.60 | $100.00 |
Providence Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
United Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
United Setting Professional Modifier None Typical Low $13.80 Median $14.79 Typical High $15.85 | Professional | None | $13.80 | $14.79 | $15.85 |
Wellpoint Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
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 $5.75 Median $9.12 Typical High $15.14 | Facility | 52 · Reduced service | $5.75 | $9.12 | $15.14 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.29 Median $3.63 Typical High $6.03 | Facility | 53 · Discontinued | $2.29 | $3.63 | $6.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.74 Median $2.75 Typical High $4.57 | Facility | 55 · Aftercare only | $1.74 | $2.75 | $4.57 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.82 Typical High $3.02 | Facility | 56 · Pre-op care only | $1.15 | $1.82 | $3.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.75 Median $5.75 Typical High $6.03 | Professional | 52 · Reduced service | $5.75 | $5.75 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $2.40 | Professional | 53 · Discontinued | $2.29 | $2.29 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.74 Typical High $1.78 | Professional | 55 · Aftercare only | $1.74 | $1.74 | $1.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.15 Typical High $1.20 | Professional | 56 · Pre-op care only | $1.15 | $1.15 | $1.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $6.92 Median $6.92 Typical High $7.24 | Professional | 52 · Reduced service | $6.92 | $6.92 | $7.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $2.88 | Professional | 53 · Discontinued | $2.82 | $2.82 | $2.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.09 Typical High $2.14 | Professional | 55 · Aftercare only | $2.09 | $2.09 | $2.14 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.38 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.38 | $1.38 | $1.45 |
Where Texas sits
The same service costs 1.8 times more in Alaska than in Kentucky. 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· 12th of 51
$13.80
AK $20.89KY $11.48
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.