How much rates vary
Facilitymedian $42 · 10th to 90th $32 to $78Professionalmedian $41 · 10th to 90th $31 to $562
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 $33.88 Median $33.88 Typical High $34.67 | Facility | None | $33.88 | $33.88 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $34.67 Typical High $43.65 | Professional | None | $33.11 | $34.67 | $43.65 |
Christus Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $41.69 | Professional | None | $30.90 | $30.90 | $41.69 |
Lucent Health Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $562.34 | Professional | None | $389.05 | $562.34 | $562.34 |
Moda Health Setting Facility Modifier None Typical Low $21.38 Median $40.74 Typical High $77.62 | Facility | None | $21.38 | $40.74 | $77.62 |
Moda Health Setting Professional Modifier None Typical Low $33.11 Median $34.67 Typical High $48.98 | Professional | None | $33.11 | $34.67 | $48.98 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $81.28 | Professional | None | $38.02 | $38.02 | $81.28 |
Providence Setting Facility Modifier None Typical Low $32.36 Median $41.69 Typical High $77.62 | Facility | None | $32.36 | $41.69 | $77.62 |
Providence Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $41.69 | Professional | None | $30.90 | $30.90 | $41.69 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $91.20 | Facility | None | $77.62 | $77.62 | $91.20 |
United Setting Professional Modifier None Typical Low $25.70 Median $37.15 Typical High $47.86 | Professional | None | $25.70 | $37.15 | $47.86 |
Wellpoint Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
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 $16.60 Median $17.38 Typical High $21.88 | Professional | 52 · Reduced service | $16.60 | $17.38 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $7.08 Typical High $8.71 | Professional | 53 · Discontinued | $6.61 | $7.08 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.25 Typical High $6.46 | Professional | 55 · Aftercare only | $5.01 | $5.25 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.47 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.31 | $3.47 | $4.37 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.60 Median $17.38 Typical High $20.89 | Professional | 52 · Reduced service | $16.60 | $17.38 | $20.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $7.08 Typical High $8.32 | Professional | 53 · Discontinued | $6.61 | $7.08 | $8.32 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.25 Typical High $6.31 | Professional | 55 · Aftercare only | $5.01 | $5.25 | $6.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.47 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.31 | $3.47 | $4.17 |
Where Texas sits
The same service costs 2.6 times more in Montana than in Delaware. 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· 25th of 51
$41.69
MT $79.43DE $30.90
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.