How much rates vary
Facilitymedian $66 · 10th to 90th $6 to $66Professionalmedian $7 · 10th to 90th $5 to $85
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 $5.50 Median $5.50 Typical High $6.03 | Facility | None | $5.50 | $5.50 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $10.96 | Professional | None | $5.50 | $5.50 | $10.96 |
Ambetter Setting Professional Modifier None Typical Low $8.91 Median $9.55 Typical High $9.55 | Professional | None | $8.91 | $9.55 | $9.55 |
BCBS Texas Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $8.71 | Professional | None | $6.03 | $6.03 | $8.71 |
Christus Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $7.08 | Professional | None | $5.25 | $5.25 | $7.08 |
Lucent Health Setting Professional Modifier None Typical Low $74.13 Median $85.11 Typical High $85.11 | Professional | None | $74.13 | $85.11 | $85.11 |
Moda Health Setting Facility Modifier None Typical Low $3.55 Median $7.08 Typical High $12.88 | Facility | None | $3.55 | $7.08 | $12.88 |
Moda Health Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $10.96 | Professional | None | $5.50 | $5.50 | $10.96 |
Molina Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $81.28 | Professional | None | $6.92 | $6.92 | $81.28 |
Providence Setting Facility Modifier None Typical Low $5.37 Median $7.08 Typical High $12.88 | Facility | None | $5.37 | $7.08 | $12.88 |
Providence Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $7.08 | Professional | None | $5.25 | $5.25 | $7.08 |
United Setting Facility Modifier None Typical Low $6.31 Median $7.94 Typical High $12.88 | Facility | None | $6.31 | $7.94 | $12.88 |
United Setting Professional Modifier None Typical Low $4.57 Median $6.92 Typical High $8.32 | Professional | None | $4.57 | $6.92 | $8.32 |
Wellpoint Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
8 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 $2.75 Median $2.75 Typical High $5.50 | Professional | 52 · Reduced service | $2.75 | $2.75 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.12 Typical High $2.19 | Professional | 53 · Discontinued | $1.12 | $1.12 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $0.83 Typical High $1.66 | Professional | 55 · Aftercare only | $0.83 | $0.83 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.55 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.55 | $0.55 | $1.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.75 Median $2.75 Typical High $5.50 | Professional | 52 · Reduced service | $2.75 | $2.75 | $5.50 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.12 Typical High $2.19 | Professional | 53 · Discontinued | $1.12 | $1.12 | $2.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $0.83 Typical High $1.66 | Professional | 55 · Aftercare only | $0.83 | $0.83 | $1.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.55 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.55 | $0.55 | $1.12 |
Where Texas sits
The same service costs 3.5 times more in Montana than in Kansas. 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· 29th of 51
$7.08
MT $15.49KS $4.37
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.