How much rates vary
Facilitymedian $7 · 10th to 90th $5 to $17Professionalmedian $5 · 10th to 90th $5 to $8
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 $5.01 Median $6.17 Typical High $10.72 | Facility | None | $5.01 | $6.17 | $10.72 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.37 Typical High $5.50 | Professional | None | $5.25 | $5.37 | $5.50 |
Ambetter Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
BCBS Texas Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
BCBS Texas Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
Baylor Scott & White Setting Professional Modifier None Typical Low $5.25 Median $6.92 Typical High $37.15 | Professional | None | $5.25 | $6.92 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $5.25 Median $10.23 Typical High $17.38 | Facility | None | $5.25 | $10.23 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Lucent Health Setting Professional Modifier None Typical Low $7.94 Median $17.78 Typical High $52.48 | Professional | None | $7.94 | $17.78 | $52.48 |
Moda Health Setting Facility Modifier None Typical Low $4.90 Median $6.03 Typical High $12.02 | Facility | None | $4.90 | $6.03 | $12.02 |
Moda Health Setting Professional Modifier None Typical Low $4.90 Median $5.01 Typical High $5.37 | Professional | None | $4.90 | $5.01 | $5.37 |
Molina Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $7.94 | Professional | None | $6.92 | $6.92 | $7.94 |
Oscar Health Setting Professional Modifier None Typical Low $5.37 Median $10.23 Typical High $18.20 | Professional | None | $5.37 | $10.23 | $18.20 |
Providence Setting Facility Modifier None Typical Low $5.25 Median $7.59 Typical High $44.67 | Facility | None | $5.25 | $7.59 | $44.67 |
Providence Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
United Setting Professional Modifier None Typical Low $4.90 Median $5.25 Typical High $5.50 | Professional | None | $4.90 | $5.25 | $5.50 |
Wellpoint Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
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 $2.63 Median $3.24 Typical High $5.37 | Facility | 52 · Reduced service | $2.63 | $3.24 | $5.37 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.07 Median $1.38 Typical High $2.14 | Facility | 53 · Discontinued | $1.07 | $1.38 | $2.14 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.79 Median $1.05 Typical High $1.62 | Facility | 55 · Aftercare only | $0.79 | $1.05 | $1.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.69 Typical High $1.07 | Facility | 56 · Pre-op care only | $0.52 | $0.69 | $1.07 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.63 Median $2.63 Typical High $2.69 | Professional | 52 · Reduced service | $2.63 | $2.63 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.07 Typical High $1.10 | Professional | 53 · Discontinued | $1.07 | $1.07 | $1.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $0.79 Typical High $0.81 | Professional | 55 · Aftercare only | $0.79 | $0.79 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.54 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $4.90 Median $4.90 Typical High $5.25 | Professional | JZ · No drug discarded | $4.90 | $4.90 | $5.25 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $1.00 Median $1.20 Typical High $2.40 | Facility | 53 · Discontinued | $1.00 | $1.20 | $2.40 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $0.74 Median $0.89 Typical High $1.82 | Facility | 55 · Aftercare only | $0.74 | $0.89 | $1.82 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $0.49 Median $0.60 Typical High $1.20 | Facility | 56 · Pre-op care only | $0.49 | $0.60 | $1.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.45 Median $2.45 Typical High $2.57 | Professional | 52 · Reduced service | $2.45 | $2.45 | $2.57 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $1.00 Typical High $1.02 | Professional | 53 · Discontinued | $1.00 | $1.00 | $1.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.74 Median $0.74 Typical High $0.76 | Professional | 55 · Aftercare only | $0.74 | $0.74 | $0.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.49 Median $0.49 Typical High $0.51 | Professional | 56 · Pre-op care only | $0.49 | $0.49 | $0.51 |
Where Texas sits
The same service costs 1.9 times more in Wyoming than in Colorado. 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
$5.25
WY $10.00CO $5.25
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.