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 $38.90 Median $38.90 Typical High $56.23 | Facility | None | $38.90 | $38.90 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $51.29 Typical High $56.23 | Professional | None | $16.60 | $51.29 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Lucent Health Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $123.03 | Professional | None | $91.20 | $123.03 | $123.03 |
Moda Health Setting Facility Modifier None Typical Low $14.79 Median $44.67 Typical High $72.44 | Facility | None | $14.79 | $44.67 | $72.44 |
Moda Health Setting Professional Modifier None Typical Low $38.02 Median $51.29 Typical High $60.26 | Professional | None | $38.02 | $51.29 | $60.26 |
Molina Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Providence Setting Facility Modifier None Typical Low $14.79 Median $44.67 Typical High $95.50 | Facility | None | $14.79 | $44.67 | $95.50 |
Providence Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
United Setting Professional Modifier None Typical Low $11.22 Median $14.45 Typical High $21.88 | Professional | None | $11.22 | $14.45 | $21.88 |
Wellpoint Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
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 $8.91 Median $25.70 Typical High $28.18 | Professional | 52 · Reduced service | $8.91 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $10.23 Typical High $11.22 | Professional | 53 · Discontinued | $3.63 | $10.23 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $7.59 Typical High $8.32 | Professional | 55 · Aftercare only | $2.82 | $7.59 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $5.13 Typical High $5.62 | Professional | 56 · Pre-op care only | $1.91 | $5.13 | $5.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $25.70 Typical High $30.20 | Professional | 52 · Reduced service | $19.05 | $25.70 | $30.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $10.23 Typical High $12.30 | Professional | 53 · Discontinued | $7.76 | $10.23 | $12.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $7.59 Typical High $9.12 | Professional | 55 · Aftercare only | $5.75 | $7.59 | $9.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.13 Typical High $6.03 | Professional | 56 · Pre-op care only | $3.89 | $5.13 | $6.03 |
Where Texas sits
The same service costs 4.9 times more in Alaska than in Connecticut. 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· 21st of 51
$16.60
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.