How much rates vary
Facilitymedian $26 · 10th to 90th $11 to $39Professionalmedian $21 · 10th to 90th $17 to $288
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 $17.38 Median $17.38 Typical High $17.78 | Facility | None | $17.38 | $17.38 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $17.78 Typical High $21.88 | Professional | None | $16.98 | $17.78 | $21.88 |
Christus Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $25.70 | Professional | None | $18.62 | $18.62 | $25.70 |
Lucent Health Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $288.40 | Professional | None | $194.98 | $288.40 | $288.40 |
Moda Health Setting Facility Modifier None Typical Low $10.96 Median $20.89 Typical High $38.90 | Facility | None | $10.96 | $20.89 | $38.90 |
Moda Health Setting Professional Modifier None Typical Low $16.98 Median $17.78 Typical High $25.12 | Professional | None | $16.98 | $17.78 | $25.12 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $81.28 | Professional | None | $21.38 | $21.38 | $81.28 |
Providence Setting Facility Modifier None Typical Low $16.22 Median $25.70 Typical High $38.90 | Facility | None | $16.22 | $25.70 | $38.90 |
Providence Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $25.70 | Professional | None | $18.62 | $18.62 | $25.70 |
United Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $46.77 | Facility | None | $39.81 | $39.81 | $46.77 |
United Setting Professional Modifier None Typical Low $13.18 Median $19.05 Typical High $24.55 | Professional | None | $13.18 | $19.05 | $24.55 |
Wellpoint Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
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 $8.51 Median $8.91 Typical High $10.96 | Professional | 52 · Reduced service | $8.51 | $8.91 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.55 Typical High $4.47 | Professional | 53 · Discontinued | $3.39 | $3.55 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.69 Typical High $3.31 | Professional | 55 · Aftercare only | $2.51 | $2.69 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.78 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.70 | $1.78 | $2.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $8.51 Median $8.91 Typical High $10.72 | Professional | 52 · Reduced service | $8.51 | $8.91 | $10.72 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.55 Typical High $4.27 | Professional | 53 · Discontinued | $3.39 | $3.55 | $4.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.69 Typical High $3.24 | Professional | 55 · Aftercare only | $2.51 | $2.69 | $3.24 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.78 Typical High $2.14 | Professional | 56 · Pre-op care only | $1.70 | $1.78 | $2.14 |
Where Texas sits
The same service costs 2.2 times more in Montana than in New Jersey. 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· 30th of 51
$21.38
MT $40.74NJ $18.62
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.