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 $15.49 Median $15.49 Typical High $16.60 | Facility | None | $15.49 | $15.49 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $15.49 Typical High $16.98 | Professional | None | $14.13 | $15.49 | $16.98 |
BCBS Texas Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $28.84 | Professional | None | $20.89 | $20.89 | $28.84 |
Lucent Health Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $245.47 | Professional | None | $208.93 | $245.47 | $245.47 |
Moda Health Setting Facility Modifier None Typical Low $14.13 Median $15.85 Typical High $41.69 | Facility | None | $14.13 | $15.85 | $41.69 |
Moda Health Setting Professional Modifier None Typical Low $14.13 Median $15.49 Typical High $16.98 | Professional | None | $14.13 | $15.49 | $16.98 |
Molina Setting Professional Modifier None Typical Low $24.55 Median $35.48 Typical High $81.28 | Professional | None | $24.55 | $35.48 | $81.28 |
Providence Setting Facility Modifier None Typical Low $14.13 Median $28.84 Typical High $30.90 | Facility | None | $14.13 | $28.84 | $30.90 |
Providence Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $28.84 | Professional | None | $20.89 | $20.89 | $28.84 |
United Setting Professional Modifier None Typical Low $13.18 Median $18.20 Typical High $31.62 | Professional | None | $13.18 | $18.20 | $31.62 |
Wellpoint Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
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 $7.08 Median $7.76 Typical High $8.51 | Professional | 52 · Reduced service | $7.08 | $7.76 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $3.09 Typical High $3.47 | Professional | 53 · Discontinued | $2.82 | $3.09 | $3.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.29 Typical High $2.57 | Professional | 55 · Aftercare only | $2.09 | $2.29 | $2.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.55 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.41 | $1.55 | $1.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.08 Median $7.76 Typical High $8.51 | Professional | 52 · Reduced service | $7.08 | $7.76 | $8.51 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $3.09 Typical High $3.47 | Professional | 53 · Discontinued | $2.82 | $3.09 | $3.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.34 Typical High $2.57 | Professional | 55 · Aftercare only | $2.09 | $2.34 | $2.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.55 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.41 | $1.55 | $1.70 |
Where Texas sits
The same service costs 4.1 times more in Wyoming than in Utah. 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· 29th of 51
$23.99
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.