How much rates vary
Facilitymedian $4 · 10th to 90th $3 to $10Professionalmedian $3 · 10th to 90th $2 to $72
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 $2.75 Median $2.75 Typical High $3.02 | Facility | None | $2.75 | $2.75 | $3.02 |
Aetna Setting Professional Modifier None Typical Low $2.57 Median $2.75 Typical High $3.63 | Professional | None | $2.57 | $2.75 | $3.63 |
BCBS Texas Setting Facility Modifier None Typical Low $7.76 Median $7.76 Typical High $9.12 | Facility | None | $7.76 | $7.76 | $9.12 |
BCBS Texas Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Cigna Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
Lucent Health Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $72.44 | Professional | None | $38.02 | $38.02 | $72.44 |
Moda Health Setting Facility Modifier None Typical Low $2.75 Median $4.27 Typical High $10.47 | Facility | None | $2.75 | $4.27 | $10.47 |
Moda Health Setting Professional Modifier None Typical Low $2.57 Median $2.75 Typical High $3.63 | Professional | None | $2.57 | $2.75 | $3.63 |
Oscar Health Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
Providence Setting Facility Modifier None Typical Low $2.75 Median $4.27 Typical High $10.47 | Facility | None | $2.75 | $4.27 | $10.47 |
Providence Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
United Setting Professional Modifier None Typical Low $1.51 Median $1.91 Typical High $2.88 | Professional | None | $1.51 | $1.91 | $2.88 |
Wellpoint Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
10 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 $1.29 Median $1.38 Typical High $1.82 | Professional | 52 · Reduced service | $1.29 | $1.38 | $1.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.51 Median $0.56 Typical High $0.72 | Professional | 53 · Discontinued | $0.51 | $0.56 | $0.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.91 Median $2.09 Typical High $2.69 | Professional | 54 · Surgery only | $1.91 | $2.09 | $2.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.38 Median $0.42 Typical High $0.54 | Professional | 55 · Aftercare only | $0.38 | $0.42 | $0.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.28 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.26 | $0.28 | $0.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.29 Median $1.38 Typical High $1.70 | Professional | 52 · Reduced service | $1.29 | $1.38 | $1.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.51 Median $0.56 Typical High $0.69 | Professional | 53 · Discontinued | $0.51 | $0.56 | $0.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1.95 Median $2.09 Typical High $2.57 | Professional | 54 · Surgery only | $1.95 | $2.09 | $2.57 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.39 Median $0.42 Typical High $0.52 | Professional | 55 · Aftercare only | $0.39 | $0.42 | $0.52 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.28 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.26 | $0.28 | $0.35 |
Where Texas sits
The same service costs 4.0 times more in Rhode Island than in New York. 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· 27th of 51
$2.82
RI $6.76NY $1.70
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.