How much rates vary
Facilitymedian $2 · 10th to 90th $2 to $21Professionalmedian $14 · 10th to 90th $7 to $107
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 $6.17 Median $6.76 Typical High $9.77 | Facility | None | $6.17 | $6.76 | $9.77 |
Aetna Setting Professional Modifier None (both parts) Typical Low $6.31 Median $6.92 Typical High $9.77 | Professional | None (both parts) | $6.31 | $6.92 | $9.77 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $7.41 Median $8.71 Typical High $19.95 | Professional | None (both parts) | $7.41 | $8.71 | $19.95 |
BCBS Texas Setting Professional Modifier None (both parts) Typical Low $12.88 Median $12.88 Typical High $14.45 | Professional | None (both parts) | $12.88 | $12.88 | $14.45 |
Christus Setting Facility Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Facility | None | $1.82 | $1.82 | $1.82 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $21.38 | Facility | None | $20.89 | $20.89 | $21.38 |
Cigna Setting Professional Modifier None (both parts) Typical Low $15.49 Median $15.49 Typical High $20.89 | Professional | None (both parts) | $15.49 | $15.49 | $20.89 |
Health Smart Setting Professional Modifier None (both parts) Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | None (both parts) | $10.23 | $10.23 | $10.23 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $89.13 Median $107.15 Typical High $107.15 | Professional | None (both parts) | $89.13 | $107.15 | $107.15 |
Moda Health Setting Facility Modifier None Typical Low $6.17 Median $11.75 Typical High $104.71 | Facility | None | $6.17 | $11.75 | $104.71 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $6.31 Median $6.92 Typical High $12.30 | Professional | None (both parts) | $6.31 | $6.92 | $12.30 |
Molina Setting Professional Modifier None (both parts) Typical Low $28.84 Median $30.20 Typical High $38.02 | Professional | None (both parts) | $28.84 | $30.20 | $38.02 |
Providence Setting Facility Modifier None Typical Low $6.17 Median $20.89 Typical High $21.38 | Facility | None | $6.17 | $20.89 | $21.38 |
Providence Setting Professional Modifier None (both parts) Typical Low $15.49 Median $15.49 Typical High $20.89 | Professional | None (both parts) | $15.49 | $15.49 | $20.89 |
United Setting Professional Modifier None (both parts) Typical Low $5.75 Median $7.94 Typical High $14.13 | Professional | None (both parts) | $5.75 | $7.94 | $14.13 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None (both parts) | $14.45 | $14.45 | $14.45 |
11 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 Professional Modifier 52 · Reduced service Typical Low $3.09 Median $3.39 Typical High $3.72 | Professional | 52 · Reduced service | $3.09 | $3.39 | $3.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.23 Median $1.35 Typical High $1.48 | Professional | 53 · Discontinued | $1.23 | $1.35 | $1.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.91 Median $1.00 Typical High $1.12 | Professional | 55 · Aftercare only | $0.91 | $1.00 | $1.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.68 Typical High $0.76 | Professional | 56 · Pre-op care only | $0.62 | $0.68 | $0.76 |
Christus Setting Professional Modifier 26 · Professional part Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 26 · Professional part | $14.45 | $14.45 | $14.45 |
Cigna Setting Professional Modifier RR · Rental Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | RR · Rental | $2.09 | $2.09 | $2.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.09 Median $3.39 Typical High $3.72 | Professional | 52 · Reduced service | $3.09 | $3.39 | $3.72 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.23 Median $1.35 Typical High $1.48 | Professional | 53 · Discontinued | $1.23 | $1.35 | $1.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.91 Median $1.00 Typical High $1.12 | Professional | 55 · Aftercare only | $0.91 | $1.00 | $1.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.68 Typical High $0.76 | Professional | 56 · Pre-op care only | $0.62 | $0.68 | $0.76 |
Providence Setting Professional Modifier RR · Rental Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | RR · Rental | $2.09 | $2.09 | $2.09 |
Where Texas sits
The same service costs 6.2 times more in Wyoming than in North Carolina. 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· 17th of 51
$14.45
WY $53.70NC $8.71
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.