How much rates vary
Facilitymedian $135 · 10th to 90th $65 to $229Professionalmedian $123 · 10th to 90th $100 to $1,549
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 $100.00 Median $100.00 Typical High $104.71 | Facility | None | $100.00 | $100.00 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $104.71 Typical High $131.83 | Professional | None | $100.00 | $104.71 | $131.83 |
Christus Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | None | $100.00 | $100.00 | $134.90 |
Lucent Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,548.82 | $1,548.82 |
Moda Health Setting Facility Modifier None Typical Low $64.57 Median $128.82 Typical High $229.09 | Facility | None | $64.57 | $128.82 | $229.09 |
Moda Health Setting Professional Modifier None Typical Low $100.00 Median $104.71 Typical High $141.25 | Professional | None | $100.00 | $104.71 | $141.25 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $123.03 | Professional | None | $81.28 | $123.03 | $123.03 |
Providence Setting Facility Modifier None Typical Low $97.72 Median $134.90 Typical High $229.09 | Facility | None | $97.72 | $134.90 | $229.09 |
Providence Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | None | $100.00 | $100.00 | $134.90 |
United Setting Facility Modifier None Typical Low $63.10 Median $128.82 Typical High $234.42 | Facility | None | $63.10 | $128.82 | $234.42 |
United Setting Professional Modifier None Typical Low $77.62 Median $112.20 Typical High $144.54 | Professional | None | $77.62 | $112.20 | $144.54 |
Wellpoint Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
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 $50.12 Median $52.48 Typical High $66.07 | Professional | 52 · Reduced service | $50.12 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $20.89 Typical High $26.30 | Professional | 53 · Discontinued | $19.95 | $20.89 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $15.85 Typical High $19.50 | Professional | 55 · Aftercare only | $14.79 | $15.85 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.47 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.00 | $10.47 | $13.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $52.48 Typical High $64.57 | Professional | 52 · Reduced service | $50.12 | $52.48 | $64.57 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $20.89 Typical High $25.70 | Professional | 53 · Discontinued | $19.95 | $20.89 | $25.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $15.85 Typical High $19.05 | Professional | 55 · Aftercare only | $14.79 | $15.85 | $19.05 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.47 Typical High $12.88 | Professional | 56 · Pre-op care only | $10.00 | $10.47 | $12.88 |
Where Texas sits
The same service costs 3.9 times more in Kansas than in New Jersey. 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· 32nd of 51
$123
KS $389NJ $100
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.