How much rates vary
Facilitymedian $145 · 10th to 90th $30 to $245Professionalmedian $27 · 10th to 90th $27 to $28
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 $26.92 Median $40.74 Typical High $58.88 | Facility | None | $26.92 | $40.74 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $29.51 | Professional | None | $26.92 | $26.92 | $29.51 |
BCBS Texas Setting Facility Modifier None Typical Low $75.86 Median $173.78 Typical High $251.19 | Facility | None | $75.86 | $173.78 | $251.19 |
BCBS Texas Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $63.10 Typical High $85.11 | Facility | None | $26.92 | $63.10 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Moda Health Setting Facility Modifier None Typical Low $26.92 Median $38.02 Typical High $64.57 | Facility | None | $26.92 | $38.02 | $64.57 |
Moda Health Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $29.51 | Professional | None | $26.92 | $26.92 | $29.51 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Providence Setting Facility Modifier None Typical Low $26.92 Median $38.02 Typical High $229.09 | Facility | None | $26.92 | $38.02 | $229.09 |
Providence Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
United Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
United Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Wellpoint Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
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 $13.18 Median $21.38 Typical High $29.51 | Facility | 52 · Reduced service | $13.18 | $21.38 | $29.51 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.37 Median $8.51 Typical High $11.75 | Facility | 53 · Discontinued | $5.37 | $8.51 | $11.75 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.98 Median $6.46 Typical High $8.71 | Facility | 55 · Aftercare only | $3.98 | $6.46 | $8.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.63 Median $4.27 Typical High $5.89 | Facility | 56 · Pre-op care only | $2.63 | $4.27 | $5.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $13.49 Typical High $14.79 | Professional | 52 · Reduced service | $13.18 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $5.89 | Professional | 53 · Discontinued | $5.37 | $5.37 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.07 Typical High $4.37 | Professional | 55 · Aftercare only | $3.98 | $4.07 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.69 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.63 | $2.69 | $2.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13.49 Median $13.49 Typical High $13.80 | Professional | 52 · Reduced service | $13.49 | $13.49 | $13.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $5.50 | Professional | 53 · Discontinued | $5.37 | $5.37 | $5.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.07 Typical High $4.17 | Professional | 55 · Aftercare only | $3.98 | $4.07 | $4.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.69 | $2.69 | $2.75 |
Where Texas sits
The same service costs 2.9 times more in Wyoming than in Minnesota. 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· 3rd of 51
$58.88
WY $77.62MN $26.92
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.