How much rates vary
Facilitymedian $9 · 10th to 90th $3 to $12Professionalmedian $2 · 10th to 90th $2 to $3
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 $2.14 Median $2.69 Typical High $4.68 | Facility | None | $2.14 | $2.69 | $4.68 |
Aetna Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.19 | Professional | None | $2.14 | $2.14 | $2.19 |
Ambetter Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
BCBS Texas Setting Facility Modifier None Typical Low $2.63 Median $6.61 Typical High $11.75 | Facility | None | $2.63 | $6.61 | $11.75 |
BCBS Texas Setting Professional Modifier None Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | None | $2.75 | $2.75 | $2.75 |
Baylor Scott & White Setting Facility Modifier None Typical Low $11.75 Median $11.75 Typical High $11.75 | Facility | None | $11.75 | $11.75 | $11.75 |
Baylor Scott & White Setting Professional Modifier None Typical Low $2.14 Median $2.19 Typical High $4.27 | Professional | None | $2.14 | $2.19 | $4.27 |
Christus Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Facility | None | $9.55 | $9.55 | $9.55 |
Cigna Setting Facility Modifier None Typical Low $2.14 Median $3.98 Typical High $6.76 | Facility | None | $2.14 | $3.98 | $6.76 |
Cigna Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
Lucent Health Setting Professional Modifier None Typical Low $2.24 Median $2.63 Typical High $4.17 | Professional | None | $2.24 | $2.63 | $4.17 |
Moda Health Setting Facility Modifier None Typical Low $2.19 Median $10.00 Typical High $19.05 | Facility | None | $2.19 | $10.00 | $19.05 |
Moda Health Setting Professional Modifier None Typical Low $2.14 Median $2.19 Typical High $2.24 | Professional | None | $2.14 | $2.19 | $2.24 |
Molina Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.24 | Professional | None | $1.95 | $1.95 | $2.24 |
Oscar Health Setting Professional Modifier None Typical Low $2.29 Median $3.89 Typical High $7.94 | Professional | None | $2.29 | $3.89 | $7.94 |
Providence Setting Facility Modifier None Typical Low $2.14 Median $3.02 Typical High $18.20 | Facility | None | $2.14 | $3.02 | $18.20 |
Providence Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
United Setting Professional Modifier None Typical Low $2.19 Median $2.29 Typical High $11.75 | Professional | None | $2.19 | $2.29 | $11.75 |
Wellpoint Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
17 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 $1.07 Median $1.51 Typical High $2.34 | Facility | 52 · Reduced service | $1.07 | $1.51 | $2.34 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.43 Median $0.62 Typical High $0.95 | Facility | 53 · Discontinued | $0.43 | $0.62 | $0.95 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.32 Median $0.46 Typical High $0.71 | Facility | 55 · Aftercare only | $0.32 | $0.46 | $0.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.30 Typical High $0.47 | Facility | 56 · Pre-op care only | $0.21 | $0.30 | $0.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.07 Median $1.07 Typical High $1.10 | Professional | 52 · Reduced service | $1.07 | $1.07 | $1.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.43 Typical High $0.44 | Professional | 53 · Discontinued | $0.43 | $0.43 | $0.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.32 Typical High $0.33 | Professional | 55 · Aftercare only | $0.32 | $0.32 | $0.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.21 Typical High $0.22 | Professional | 56 · Pre-op care only | $0.21 | $0.21 | $0.22 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $2.14 Median $2.14 Typical High $2.19 | Professional | JZ · No drug discarded | $2.14 | $2.14 | $2.19 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $1.10 Median $1.32 Typical High $2.63 | Facility | 52 · Reduced service | $1.10 | $1.32 | $2.63 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $0.43 Median $0.52 Typical High $1.05 | Facility | 53 · Discontinued | $0.43 | $0.52 | $1.05 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $0.33 Median $0.39 Typical High $0.79 | Facility | 55 · Aftercare only | $0.33 | $0.39 | $0.79 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.26 Typical High $0.52 | Facility | 56 · Pre-op care only | $0.22 | $0.26 | $0.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.10 Median $1.10 Typical High $1.12 | Professional | 52 · Reduced service | $1.10 | $1.10 | $1.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.43 Typical High $0.45 | Professional | 53 · Discontinued | $0.43 | $0.43 | $0.45 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.33 Typical High $0.33 | Professional | 55 · Aftercare only | $0.33 | $0.33 | $0.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $0.22 |
Where Texas sits
The same service costs 1.9 times more in Wyoming than in Maine. 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· 44th of 51
$2.14
WY $4.07ME $2.14
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.