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 $27.54 Median $27.54 Typical High $29.51 | Facility | None | $27.54 | $27.54 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $27.54 Typical High $30.90 | Professional | None | $25.12 | $27.54 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
Lucent Health Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $446.68 | Professional | None | $371.54 | $446.68 | $446.68 |
Moda Health Setting Facility Modifier None Typical Low $25.12 Median $28.84 Typical High $74.13 | Facility | None | $25.12 | $28.84 | $74.13 |
Moda Health Setting Professional Modifier None Typical Low $25.12 Median $27.54 Typical High $30.90 | Professional | None | $25.12 | $27.54 | $30.90 |
Molina Setting Professional Modifier None Typical Low $10.96 Median $15.49 Typical High $81.28 | Professional | None | $10.96 | $15.49 | $81.28 |
Providence Setting Facility Modifier None Typical Low $25.12 Median $50.12 Typical High $53.70 | Facility | None | $25.12 | $50.12 | $53.70 |
Providence Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
United Setting Professional Modifier None Typical Low $23.99 Median $32.36 Typical High $57.54 | Professional | None | $23.99 | $32.36 | $57.54 |
Wellpoint Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
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 $12.59 Median $13.80 Typical High $15.49 | Professional | 52 · Reduced service | $12.59 | $13.80 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.50 Typical High $6.17 | Professional | 53 · Discontinued | $5.01 | $5.50 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $4.17 Typical High $4.57 | Professional | 55 · Aftercare only | $3.80 | $4.17 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.75 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.51 | $2.75 | $3.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.59 Median $13.80 Typical High $15.49 | Professional | 52 · Reduced service | $12.59 | $13.80 | $15.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.50 Typical High $6.17 | Professional | 53 · Discontinued | $5.01 | $5.50 | $6.17 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $4.17 Typical High $4.57 | Professional | 55 · Aftercare only | $3.80 | $4.17 | $4.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.75 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.51 | $2.75 | $3.09 |
Where Texas sits
The same service costs 4.1 times more in Kansas 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· 46th of 51
$36.31
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.