How much rates vary
Facilitymedian $4 · 10th to 90th $1 to $11Professionalmedian $1 · 10th to 90th $1 to $7
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 $1.32 Median $1.78 Typical High $2.95 | Facility | None | $1.32 | $1.78 | $2.95 |
Aetna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.35 | Professional | None | $1.32 | $1.32 | $1.35 |
Ambetter Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
BCBS Texas Setting Facility Modifier None Typical Low $5.62 Median $8.51 Typical High $12.30 | Facility | None | $5.62 | $8.51 | $12.30 |
BCBS Texas Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | None | $7.41 | $7.41 | $7.41 |
Baylor Scott & White Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.82 | Professional | None | $1.32 | $1.32 | $1.82 |
Cigna Setting Facility Modifier None Typical Low $1.29 Median $2.51 Typical High $4.17 | Facility | None | $1.29 | $2.51 | $4.17 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Lucent Health Setting Professional Modifier None Typical Low $1.51 Median $2.24 Typical High $5.13 | Professional | None | $1.51 | $2.24 | $5.13 |
Moda Health Setting Facility Modifier None Typical Low $1.32 Median $1.78 Typical High $3.63 | Facility | None | $1.32 | $1.78 | $3.63 |
Moda Health Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.38 | Professional | None | $1.32 | $1.32 | $1.38 |
Molina Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.51 | Professional | None | $1.32 | $1.32 | $1.51 |
Oscar Health Setting Professional Modifier None Typical Low $1.45 Median $2.82 Typical High $4.90 | Professional | None | $1.45 | $2.82 | $4.90 |
Providence Setting Facility Modifier None Typical Low $1.32 Median $1.91 Typical High $11.22 | Facility | None | $1.32 | $1.91 | $11.22 |
Providence Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
United Setting Professional Modifier None Typical Low $1.32 Median $1.41 Typical High $1.51 | Professional | None | $1.32 | $1.41 | $1.51 |
Wellpoint Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | None | $1.70 | $1.70 | $1.70 |
16 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 $0.66 Median $0.87 Typical High $1.45 | Facility | 52 · Reduced service | $0.66 | $0.87 | $1.45 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.26 Median $0.37 Typical High $0.58 | Facility | 53 · Discontinued | $0.26 | $0.37 | $0.58 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.20 Median $0.28 Typical High $0.44 | Facility | 55 · Aftercare only | $0.20 | $0.28 | $0.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.18 Typical High $0.28 | Facility | 56 · Pre-op care only | $0.13 | $0.18 | $0.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.66 Median $0.66 Typical High $0.68 | Professional | 52 · Reduced service | $0.66 | $0.66 | $0.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.26 Typical High $0.27 | Professional | 53 · Discontinued | $0.26 | $0.26 | $0.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.13 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | JZ · No drug discarded | $1.32 | $1.32 | $1.32 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $0.27 Median $0.32 Typical High $0.65 | Facility | 53 · Discontinued | $0.27 | $0.32 | $0.65 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $0.20 Median $0.24 Typical High $0.49 | Facility | 55 · Aftercare only | $0.20 | $0.24 | $0.49 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.16 Typical High $0.32 | Facility | 56 · Pre-op care only | $0.13 | $0.16 | $0.32 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.68 Median $0.68 Typical High $0.69 | Professional | 52 · Reduced service | $0.68 | $0.68 | $0.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | 53 · Discontinued | $0.27 | $0.27 | $0.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $0.21 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $0.21 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.14 |
Where Texas sits
The same service costs 1.9 times more in Wyoming than in Florida. 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· 23rd of 51
$1.32
WY $2.45FL $1.32
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.