How much rates vary
Facilitymedian $3 · 10th to 90th $1 to $5Professionalmedian $1 · 10th to 90th $1 to $5
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 $0.79 Median $1.26 Typical High $1.74 | Facility | None | $0.79 | $1.26 | $1.74 |
Aetna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.81 | Professional | None | $0.79 | $0.79 | $0.81 |
BCBS Texas Setting Facility Modifier None Typical Low $1.29 Median $2.88 Typical High $5.37 | Facility | None | $1.29 | $2.88 | $5.37 |
BCBS Texas Setting Professional Modifier None Typical Low $0.78 Median $0.78 Typical High $0.78 | Professional | None | $0.78 | $0.78 | $0.78 |
Baylor Scott & White Setting Facility Modifier None Typical Low $0.68 Median $1.10 Typical High $5.89 | Facility | None | $0.68 | $1.10 | $5.89 |
Cigna Setting Facility Modifier None Typical Low $0.79 Median $1.51 Typical High $2.51 | Facility | None | $0.79 | $1.51 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Lucent Health Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Moda Health Setting Facility Modifier None Typical Low $0.79 Median $1.12 Typical High $2.40 | Facility | None | $0.79 | $1.12 | $2.40 |
Moda Health Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.81 | Professional | None | $0.79 | $0.79 | $0.81 |
Molina Setting Professional Modifier None Typical Low $0.76 Median $0.79 Typical High $0.79 | Professional | None | $0.76 | $0.79 | $0.79 |
Oscar Health Setting Professional Modifier None Typical Low $0.81 Median $1.41 Typical High $2.88 | Professional | None | $0.81 | $1.41 | $2.88 |
Providence Setting Facility Modifier None Typical Low $0.79 Median $1.15 Typical High $6.92 | Facility | None | $0.79 | $1.15 | $6.92 |
Providence Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
United Setting Professional Modifier None Typical Low $0.79 Median $0.83 Typical High $0.89 | Professional | None | $0.79 | $0.83 | $0.89 |
Wellpoint Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | None | $0.76 | $0.76 | $0.76 |
15 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 $0.40 Median $0.63 Typical High $0.85 | Facility | 52 · Reduced service | $0.40 | $0.63 | $0.85 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.16 Median $0.25 Typical High $0.35 | Facility | 53 · Discontinued | $0.16 | $0.25 | $0.35 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.12 Median $0.19 Typical High $0.26 | Facility | 55 · Aftercare only | $0.12 | $0.19 | $0.26 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.13 Typical High $0.17 | Facility | 56 · Pre-op care only | $0.08 | $0.13 | $0.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.40 Median $0.40 Typical High $0.41 | Professional | 52 · Reduced service | $0.40 | $0.40 | $0.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 53 · Discontinued | $0.16 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.40 Median $0.40 Typical High $0.41 | Professional | 52 · Reduced service | $0.40 | $0.40 | $0.41 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 53 · Discontinued | $0.16 | $0.16 | $0.16 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.08 |
Moda Health Setting Professional Modifier EC · Anemia drug, other cause Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | EC · Anemia drug, other cause | $6.92 | $6.92 | $6.92 |
Moda Health Setting Professional Modifier JA · Given by IV Typical Low $4.07 Median $4.90 Typical High $6.46 | Professional | JA · Given by IV | $4.07 | $4.90 | $6.46 |
Moda Health Setting Professional Modifier JB · Given under the skin Typical Low $0.51 Median $0.51 Typical High $6.03 | Professional | JB · Given under the skin | $0.51 | $0.51 | $6.03 |
Where Texas sits
Rates are fairly even across states for this service. 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· 45th of 51
$0.79
WY $1.12WV $0.79
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.