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 $16.22 Median $16.22 Typical High $17.38 | Facility | None | $16.22 | $16.22 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $16.22 Typical High $18.20 | Professional | None | $14.79 | $16.22 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
Lucent Health Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $263.03 | Professional | None | $218.78 | $263.03 | $263.03 |
Moda Health Setting Facility Modifier None Typical Low $15.14 Median $16.98 Typical High $44.67 | Facility | None | $15.14 | $16.98 | $44.67 |
Moda Health Setting Professional Modifier None Typical Low $14.79 Median $16.22 Typical High $18.20 | Professional | None | $14.79 | $16.22 | $18.20 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $50.12 Typical High $81.28 | Professional | None | $32.36 | $50.12 | $81.28 |
Providence Setting Facility Modifier None Typical Low $15.14 Median $54.95 Typical High $54.95 | Facility | None | $15.14 | $54.95 | $54.95 |
Providence Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
United Setting Professional Modifier None Typical Low $14.13 Median $19.50 Typical High $33.88 | Professional | None | $14.13 | $19.50 | $33.88 |
Wellpoint Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
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 $7.41 Median $8.13 Typical High $9.12 | Professional | 52 · Reduced service | $7.41 | $8.13 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $3.24 Typical High $3.63 | Professional | 53 · Discontinued | $2.95 | $3.24 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.45 Typical High $2.69 | Professional | 55 · Aftercare only | $2.24 | $2.45 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $1.62 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.48 | $1.62 | $1.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.41 Median $8.13 Typical High $9.12 | Professional | 52 · Reduced service | $7.41 | $8.13 | $9.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $3.24 Typical High $3.63 | Professional | 53 · Discontinued | $2.95 | $3.24 | $3.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $2.45 Typical High $2.69 | Professional | 55 · Aftercare only | $2.24 | $2.45 | $2.69 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $1.62 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.48 | $1.62 | $1.82 |
Where Texas sits
The same service costs 8.9 times more in North Dakota 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· 19th of 51
$39.81
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.