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 $93.33 Median $97.72 Typical High $97.72 | Facility | None | $93.33 | $97.72 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $95.50 Typical High $102.33 | Professional | None | $93.33 | $95.50 | $102.33 |
Christus Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Lucent Health Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $977.24 | Professional | None | $724.44 | $977.24 | $977.24 |
Moda Health Setting Facility Modifier None Typical Low $97.72 Median $117.49 Typical High $134.90 | Facility | None | $97.72 | $117.49 | $134.90 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $95.50 Typical High $102.33 | Professional | None | $93.33 | $95.50 | $102.33 |
Molina Setting Professional Modifier None Typical Low $15.14 Median $83.18 Typical High $112.20 | Professional | None | $15.14 | $83.18 | $112.20 |
Providence Setting Facility Modifier None Typical Low $97.72 Median $123.03 Typical High $141.25 | Facility | None | $97.72 | $123.03 | $141.25 |
Providence Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
United Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $169.82 | Professional | None | $93.33 | $120.23 | $169.82 |
Wellpoint Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
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 $46.77 Median $46.77 Typical High $51.29 | Professional | 52 · Reduced service | $46.77 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.05 Typical High $20.42 | Professional | 53 · Discontinued | $18.62 | $19.05 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.13 Typical High $15.49 | Professional | 55 · Aftercare only | $13.80 | $14.13 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.55 Typical High $10.23 | Professional | 56 · Pre-op care only | $9.33 | $9.55 | $10.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $46.77 Typical High $48.98 | Professional | 52 · Reduced service | $46.77 | $46.77 | $48.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.05 Typical High $19.50 | Professional | 53 · Discontinued | $18.62 | $19.05 | $19.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.13 Typical High $14.79 | Professional | 55 · Aftercare only | $13.80 | $14.13 | $14.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.55 Typical High $9.77 | Professional | 56 · Pre-op care only | $9.33 | $9.55 | $9.77 |
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· 44th of 51
$110
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.