How much rates vary
Facilitymedian $26 · 10th to 90th $11 to $50Professionalmedian $8 · 10th to 90th $8 to $9
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 $7.94 Median $12.02 Typical High $17.38 | Facility | None | $7.94 | $12.02 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $7.94 Median $8.13 Typical High $8.71 | Professional | None | $7.94 | $8.13 | $8.71 |
BCBS Texas Setting Facility Modifier None Typical Low $12.88 Median $28.84 Typical High $52.48 | Facility | None | $12.88 | $28.84 | $52.48 |
BCBS Texas Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
Cigna Setting Facility Modifier None Typical Low $7.94 Median $15.14 Typical High $25.70 | Facility | None | $7.94 | $15.14 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
Moda Health Setting Facility Modifier None Typical Low $7.94 Median $11.48 Typical High $47.86 | Facility | None | $7.94 | $11.48 | $47.86 |
Moda Health Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $8.71 | Professional | None | $7.94 | $7.94 | $8.71 |
Molina Setting Professional Modifier None Typical Low $6.92 Median $7.59 Typical High $7.59 | Professional | None | $6.92 | $7.59 | $7.59 |
Providence Setting Facility Modifier None Typical Low $7.94 Median $11.48 Typical High $67.61 | Facility | None | $7.94 | $11.48 | $67.61 |
Providence Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
United Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Facility | None | $7.94 | $7.94 | $7.94 |
United Setting Professional Modifier None Typical Low $7.94 Median $8.51 Typical High $8.71 | Professional | None | $7.94 | $8.51 | $8.71 |
Wellpoint Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
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 $3.98 Median $6.31 Typical High $8.51 | Facility | 52 · Reduced service | $3.98 | $6.31 | $8.51 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.58 Median $2.51 Typical High $3.47 | Facility | 53 · Discontinued | $1.58 | $2.51 | $3.47 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.20 Median $1.91 Typical High $2.57 | Facility | 55 · Aftercare only | $1.20 | $1.91 | $2.57 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.79 Median $1.26 Typical High $1.74 | Facility | 56 · Pre-op care only | $0.79 | $1.26 | $1.74 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.98 Median $4.07 Typical High $4.37 | Professional | 52 · Reduced service | $3.98 | $4.07 | $4.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.58 Median $1.62 Typical High $1.74 | Professional | 53 · Discontinued | $1.58 | $1.62 | $1.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.20 Median $1.20 Typical High $1.32 | Professional | 55 · Aftercare only | $1.20 | $1.20 | $1.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $0.81 Typical High $0.87 | Professional | 56 · Pre-op care only | $0.79 | $0.81 | $0.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.98 Median $3.98 Typical High $4.07 | Professional | 52 · Reduced service | $3.98 | $3.98 | $4.07 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.58 Median $1.58 Typical High $1.62 | Professional | 53 · Discontinued | $1.58 | $1.58 | $1.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.17 Median $1.20 Typical High $1.23 | Professional | 55 · Aftercare only | $1.17 | $1.20 | $1.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $0.79 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.79 | $0.79 | $0.81 |
Where Texas sits
The same service costs 1.9 times more in Oklahoma than in Florida. 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· 2nd of 51
$14.79
OK $15.49FL $7.94
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.