How much rates vary
Facilitymedian $4 · 10th to 90th $0 to $8Professionalmedian $0 · 10th to 90th $0 to $0
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 $0.36 Median $0.37 Typical High $0.38 | Facility | None | $0.36 | $0.37 | $0.38 |
Aetna Setting Professional Modifier None Typical Low $0.36 Median $0.37 Typical High $0.38 | Professional | None | $0.36 | $0.37 | $0.38 |
BCBS Texas Setting Facility Modifier None Typical Low $1.95 Median $5.13 Typical High $7.94 | Facility | None | $1.95 | $5.13 | $7.94 |
BCBS Texas Setting Professional Modifier None Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | None | $0.37 | $0.37 | $0.37 |
Cigna Setting Facility Modifier None Typical Low $0.37 Median $0.87 Typical High $1.17 | Facility | None | $0.37 | $0.87 | $1.17 |
Cigna Setting Professional Modifier None Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | None | $0.37 | $0.37 | $0.37 |
Moda Health Setting Facility Modifier None Typical Low $0.23 Median $1.82 Typical High $5.13 | Facility | None | $0.23 | $1.82 | $5.13 |
Moda Health Setting Professional Modifier None Typical Low $0.23 Median $0.23 Typical High $0.36 | Professional | None | $0.23 | $0.23 | $0.36 |
Molina Setting Professional Modifier None Typical Low $0.23 Median $0.36 Typical High $0.37 | Professional | None | $0.23 | $0.36 | $0.37 |
Providence Setting Facility Modifier None Typical Low $0.37 Median $0.52 Typical High $3.16 | Facility | None | $0.37 | $0.52 | $3.16 |
Providence Setting Professional Modifier None Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | None | $0.37 | $0.37 | $0.37 |
United Setting Facility Modifier None Typical Low $0.37 Median $0.37 Typical High $0.37 | Facility | None | $0.37 | $0.37 | $0.37 |
United Setting Professional Modifier None Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | None | $0.23 | $0.23 | $0.23 |
Wellpoint Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | None | $0.36 | $0.36 | $0.36 |
9 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 $0.19 Median $0.19 Typical High $0.19 | Professional | 52 · Reduced service | $0.19 | $0.19 | $0.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.08 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $0.89 Median $2.40 Typical High $4.17 | Facility | JZ · No drug discarded | $0.89 | $2.40 | $4.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 52 · Reduced service | $0.12 | $0.12 | $0.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 53 · Discontinued | $0.05 | $0.05 | $0.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $0.04 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $0.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Where Texas sits
The same service costs 7.8 times more in Texas than in Maryland. 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· 1st of 51
$1.78
TX $1.78MD $0.23
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.