How much rates vary
Facilitymedian $7 · 10th to 90th $5 to $10Professionalmedian $5 · 10th to 90th $3 to $66
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 $4.68 Median $4.68 Typical High $5.13 | Facility | None | $4.68 | $4.68 | $5.13 |
Aetna Setting Professional Modifier None Typical Low $4.37 Median $4.79 Typical High $6.03 | Professional | None | $4.37 | $4.79 | $6.03 |
BCBS Texas Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $15.49 | Facility | None | $13.18 | $13.18 | $15.49 |
BCBS Texas Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | None | $5.89 | $5.89 | $5.89 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
Lucent Health Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $66.07 | Professional | None | $54.95 | $54.95 | $66.07 |
Moda Health Setting Facility Modifier None Typical Low $4.68 Median $7.41 Typical High $9.55 | Facility | None | $4.68 | $7.41 | $9.55 |
Moda Health Setting Professional Modifier None Typical Low $4.37 Median $4.79 Typical High $6.31 | Professional | None | $4.37 | $4.79 | $6.31 |
Oscar Health Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Providence Setting Facility Modifier None Typical Low $4.79 Median $7.41 Typical High $9.55 | Facility | None | $4.79 | $7.41 | $9.55 |
Providence Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
United Setting Professional Modifier None Typical Low $2.51 Median $3.31 Typical High $5.01 | Professional | None | $2.51 | $3.31 | $5.01 |
Wellpoint Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | None | $7.41 | $7.41 | $7.41 |
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 $2.19 Median $2.34 Typical High $3.02 | Professional | 52 · Reduced service | $2.19 | $2.34 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $0.95 Typical High $1.20 | Professional | 53 · Discontinued | $0.87 | $0.95 | $1.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.24 Median $3.55 Typical High $4.57 | Professional | 54 · Surgery only | $3.24 | $3.55 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.71 Typical High $0.91 | Professional | 55 · Aftercare only | $0.65 | $0.71 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.44 Median $0.47 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.44 | $0.47 | $0.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.19 Median $2.34 Typical High $2.88 | Professional | 52 · Reduced service | $2.19 | $2.34 | $2.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $0.95 Typical High $1.15 | Professional | 53 · Discontinued | $0.87 | $0.95 | $1.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $3.24 Median $3.55 Typical High $4.37 | Professional | 54 · Surgery only | $3.24 | $3.55 | $4.37 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.71 Typical High $0.87 | Professional | 55 · Aftercare only | $0.65 | $0.71 | $0.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.44 Median $0.47 Typical High $0.58 | Professional | 56 · Pre-op care only | $0.44 | $0.47 | $0.58 |
Where Texas sits
The same service costs 2.7 times more in Hawaii 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· 25th of 51
$4.79
HI $7.94NY $2.95
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.