How much rates vary
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 $41.69 Median $44.67 Typical High $44.67 | Facility | None | $41.69 | $44.67 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $42.66 Typical High $45.71 | Professional | None | $41.69 | $42.66 | $45.71 |
BCBS Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $190.55 | Professional | None | $44.67 | $44.67 | $190.55 |
Christus Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Lucent Health Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $446.68 | Professional | None | $331.13 | $446.68 | $446.68 |
Moda Health Setting Facility Modifier None Typical Low $44.67 Median $52.48 Typical High $61.66 | Facility | None | $44.67 | $52.48 | $61.66 |
Moda Health Setting Professional Modifier None Typical Low $41.69 Median $42.66 Typical High $46.77 | Professional | None | $41.69 | $42.66 | $46.77 |
Molina Setting Professional Modifier None Typical Low $5.01 Median $28.18 Typical High $37.15 | Professional | None | $5.01 | $28.18 | $37.15 |
Providence Setting Facility Modifier None Typical Low $44.67 Median $54.95 Typical High $64.57 | Facility | None | $44.67 | $54.95 | $64.57 |
Providence Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
United Setting Professional Modifier None Typical Low $41.69 Median $54.95 Typical High $77.62 | Professional | None | $41.69 | $54.95 | $77.62 |
Wellpoint Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
8 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 $20.89 Median $21.38 Typical High $22.91 | Professional | 52 · Reduced service | $20.89 | $21.38 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.51 Typical High $9.12 | Professional | 53 · Discontinued | $8.32 | $8.51 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.46 Typical High $6.92 | Professional | 55 · Aftercare only | $6.31 | $6.46 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.27 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.17 | $4.27 | $4.57 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $21.38 Typical High $22.39 | Professional | 52 · Reduced service | $20.89 | $21.38 | $22.39 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.51 Typical High $8.91 | Professional | 53 · Discontinued | $8.32 | $8.51 | $8.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.46 Typical High $6.76 | Professional | 55 · Aftercare only | $6.31 | $6.46 | $6.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.27 Typical High $4.47 | Professional | 56 · Pre-op care only | $4.17 | $4.27 | $4.47 |
Where Texas sits
The same service costs 3.0 times more in Alaska 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· 35th of 51
$48.98
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.