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 $14.45 Median $14.45 Typical High $15.49 | Facility | None | $14.45 | $14.45 | $15.49 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $14.45 Typical High $16.22 | Professional | None | $13.18 | $14.45 | $16.22 |
BCBS Texas Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $27.54 | Professional | None | $19.95 | $19.95 | $27.54 |
Lucent Health Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $234.42 | Professional | None | $194.98 | $234.42 | $234.42 |
Moda Health Setting Facility Modifier None Typical Low $13.18 Median $15.14 Typical High $38.90 | Facility | None | $13.18 | $15.14 | $38.90 |
Moda Health Setting Professional Modifier None Typical Low $13.18 Median $14.45 Typical High $16.22 | Professional | None | $13.18 | $14.45 | $16.22 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $38.90 Typical High $81.28 | Professional | None | $26.92 | $38.90 | $81.28 |
Providence Setting Facility Modifier None Typical Low $13.18 Median $27.54 Typical High $29.51 | Facility | None | $13.18 | $27.54 | $29.51 |
Providence Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $27.54 | Professional | None | $19.95 | $19.95 | $27.54 |
United Setting Professional Modifier None Typical Low $12.30 Median $17.38 Typical High $30.20 | Professional | None | $12.30 | $17.38 | $30.20 |
Wellpoint Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
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 $6.61 Median $7.24 Typical High $8.13 | Professional | 52 · Reduced service | $6.61 | $7.24 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.88 Typical High $3.24 | Professional | 53 · Discontinued | $2.63 | $2.88 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.19 Typical High $2.40 | Professional | 55 · Aftercare only | $2.00 | $2.19 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.45 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.32 | $1.45 | $1.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $6.61 Median $7.24 Typical High $8.13 | Professional | 52 · Reduced service | $6.61 | $7.24 | $8.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.88 Typical High $3.24 | Professional | 53 · Discontinued | $2.63 | $2.88 | $3.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.19 Typical High $2.40 | Professional | 55 · Aftercare only | $2.00 | $2.19 | $2.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.45 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.32 | $1.45 | $1.62 |
Where Texas sits
The same service costs 4.4 times more in Wyoming than in Colorado. 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· 20th of 51
$26.30
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.