How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $5Professionalmedian $1 · 10th to 90th $1 to $1
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 $1.00 Median $1.17 Typical High $1.95 | Facility | None | $1.00 | $1.17 | $1.95 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $0.50 Median $0.63 Typical High $0.98 | Facility | 52 · Reduced service | $0.50 | $0.63 | $0.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.20 Median $0.25 Typical High $0.39 | Facility | 53 · Discontinued | $0.20 | $0.25 | $0.39 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.15 Median $0.18 Typical High $0.28 | Facility | 55 · Aftercare only | $0.15 | $0.18 | $0.28 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.11 Typical High $0.20 | Facility | 56 · Pre-op care only | $0.10 | $0.11 | $0.20 |
Aetna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.05 | Professional | None | $1.02 | $1.02 | $1.05 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.51 Median $0.51 Typical High $0.52 | Professional | 52 · Reduced service | $0.51 | $0.51 | $0.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.20 Typical High $0.21 | Professional | 53 · Discontinued | $0.20 | $0.20 | $0.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.15 Typical High $0.16 | Professional | 55 · Aftercare only | $0.15 | $0.15 | $0.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.11 |
Ambetter Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.17 | Professional | None | $1.02 | $1.02 | $1.17 |
BCBS Texas Setting Facility Modifier None Typical Low $0.65 Median $1.74 Typical High $3.31 | Facility | None | $0.65 | $1.74 | $3.31 |
BCBS Texas Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
Cigna Setting Professional Modifier None Typical Low $1.07 Median $1.07 Typical High $1.17 | Professional | None | $1.07 | $1.07 | $1.17 |
Lucent Health Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.91 | Professional | None | $1.02 | $1.02 | $1.91 |
Moda Health Setting Facility Modifier None Typical Low $0.91 Median $4.47 Typical High $7.24 | Facility | None | $0.91 | $4.47 | $7.24 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $0.45 Median $0.55 Typical High $0.93 | Facility | 52 · Reduced service | $0.45 | $0.55 | $0.93 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $0.18 Median $0.22 Typical High $0.37 | Facility | 53 · Discontinued | $0.18 | $0.22 | $0.37 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $0.14 Median $0.16 Typical High $0.28 | Facility | 55 · Aftercare only | $0.14 | $0.16 | $0.28 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.11 Typical High $0.19 | Facility | 56 · Pre-op care only | $0.09 | $0.11 | $0.19 |
Moda Health Setting Professional Modifier None Typical Low $0.89 Median $0.91 Typical High $1.02 | Professional | None | $0.89 | $0.91 | $1.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.45 Median $0.45 Typical High $0.47 | Professional | 52 · Reduced service | $0.45 | $0.45 | $0.47 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.18 Median $0.18 Typical High $0.19 | Professional | 53 · Discontinued | $0.18 | $0.18 | $0.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 55 · Aftercare only | $0.14 | $0.14 | $0.14 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.09 |
Molina Setting Professional Modifier None Typical Low $0.89 Median $1.02 Typical High $1.05 | Professional | None | $0.89 | $1.02 | $1.05 |
Oscar Health Setting Professional Modifier None Typical Low $0.98 Median $1.86 Typical High $3.31 | Professional | None | $0.98 | $1.86 | $3.31 |
Providence Setting Facility Modifier None Typical Low $0.55 Median $1.02 Typical High $1.48 | Facility | None | $0.55 | $1.02 | $1.48 |
Providence Setting Professional Modifier None Typical Low $1.17 Median $1.23 Typical High $1.86 | Professional | None | $1.17 | $1.23 | $1.86 |
United Setting Professional Modifier None Typical Low $0.89 Median $0.95 Typical High $3.47 | Professional | None | $0.89 | $0.95 | $3.47 |
Wellpoint Setting Professional Modifier None Typical Low $1.05 Median $1.05 Typical High $1.05 | Professional | None | $1.05 | $1.05 | $1.05 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | JW · Drug discarded | $1.02 | $1.02 | $1.02 |
Where Texas sits
The same service costs 1.5 times more in Alaska than in New Mexico. 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
$1.02
AK $1.35NM $0.89
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.