How much rates vary
Facilitymedian $1 · 10th to 90th $0 to $2Professionalmedian $0 · 10th to 90th $0 to $219
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 $0.52 Median $0.52 Typical High $1.26 | Facility | None | $0.52 | $0.52 | $1.26 |
Aetna Setting Professional Modifier None Typical Low $0.48 Median $0.52 Typical High $0.52 | Professional | None | $0.48 | $0.52 | $0.52 |
BCBS Texas Setting Facility Modifier None Typical Low $0.31 Median $0.76 Typical High $1.41 | Facility | None | $0.31 | $0.76 | $1.41 |
BCBS Texas Setting Professional Modifier None Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | None | $0.14 | $0.14 | $0.14 |
Cigna Setting Facility Modifier None Typical Low $0.48 Median $0.72 Typical High $1.51 | Facility | None | $0.48 | $0.72 | $1.51 |
Cigna Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | None | $0.48 | $0.48 | $0.48 |
Lucent Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Moda Health Setting Facility Modifier None Typical Low $0.52 Median $0.76 Typical High $2.69 | Facility | None | $0.52 | $0.76 | $2.69 |
Moda Health Setting Professional Modifier None Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | None | $0.52 | $0.52 | $0.52 |
Molina Setting Professional Modifier None Typical Low $1.66 Median $1.78 Typical High $30.20 | Professional | None | $1.66 | $1.78 | $30.20 |
Providence Setting Facility Modifier None Typical Low $0.48 Median $0.59 Typical High $4.07 | Facility | None | $0.48 | $0.59 | $4.07 |
Providence Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | None | $0.48 | $0.48 | $0.48 |
United Setting Professional Modifier None Typical Low $0.47 Median $0.47 Typical High $0.48 | Professional | None | $0.47 | $0.47 | $0.48 |
Wellpoint Setting Professional Modifier None Typical Low $0.47 Median $0.47 Typical High $0.47 | Professional | None | $0.47 | $0.47 | $0.47 |
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 $0.26 Median $0.27 Typical High $0.27 | Professional | 52 · Reduced service | $0.26 | $0.27 | $0.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.11 Typical High $0.11 | Professional | 53 · Discontinued | $0.10 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.26 Median $0.27 Typical High $0.27 | Professional | 52 · Reduced service | $0.26 | $0.27 | $0.27 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.11 Typical High $0.11 | Professional | 53 · Discontinued | $0.10 | $0.11 | $0.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.08 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Where Texas sits
The same service costs 2.3 times more in Montana than in Michigan. 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· 42nd of 51
$0.48
MT $1.05MI $0.45
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.