How much rates vary
Facilitymedian $0 · 10th to 90th $0 to $1Professionalmedian $0 · 10th to 90th $0 to $851
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 $0.34 Median $0.54 Typical High $0.72 | Facility | None | $0.34 | $0.54 | $0.72 |
Aetna Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $0.35 | Professional | None | $0.34 | $0.34 | $0.35 |
BCBS Texas Setting Facility Modifier None Typical Low $0.10 Median $0.27 Typical High $0.51 | Facility | None | $0.10 | $0.27 | $0.51 |
Cigna Setting Facility Modifier None Typical Low $0.36 Median $0.85 Typical High $1.15 | Facility | None | $0.36 | $0.85 | $1.15 |
Cigna Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | None | $0.36 | $0.36 | $0.36 |
Lucent Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $0.34 Median $0.72 Typical High $1.82 | Facility | None | $0.34 | $0.72 | $1.82 |
Moda Health Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | None | $0.34 | $0.34 | $0.34 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $0.36 Median $0.49 Typical High $3.09 | Facility | None | $0.36 | $0.49 | $3.09 |
Providence Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | None | $0.36 | $0.36 | $0.36 |
United Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.36 | Professional | None | $0.35 | $0.35 | $0.36 |
Wellpoint Setting Professional Modifier None Typical Low $0.33 Median $0.33 Typical High $0.33 | Professional | None | $0.33 | $0.33 | $0.33 |
12 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 $0.17 Median $0.27 Typical High $0.37 | Facility | 52 · Reduced service | $0.17 | $0.27 | $0.37 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.07 Median $0.11 Typical High $0.15 | Facility | 53 · Discontinued | $0.07 | $0.11 | $0.15 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.05 Median $0.08 Typical High $0.11 | Facility | 55 · Aftercare only | $0.05 | $0.08 | $0.11 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.05 Typical High $0.07 | Facility | 56 · Pre-op care only | $0.03 | $0.05 | $0.07 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.17 Median $0.17 Typical High $0.18 | Professional | 52 · Reduced service | $0.17 | $0.17 | $0.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 52 · Reduced service | $0.17 | $0.17 | $0.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.03 |
Where Texas sits
The same service costs 1.6 times more in Alaska than in Hawaii. 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· 18th of 51
$0.36
AK $0.52HI $0.33
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.