How much rates vary
Facilitymedian $36 · 10th to 90th $19 to $54Professionalmedian $30 · 10th to 90th $23 to $389
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 $23.44 Median $23.44 Typical High $24.55 | Facility | None | $23.44 | $23.44 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $24.55 Typical High $30.20 | Professional | None | $22.91 | $24.55 | $30.20 |
Christus Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $36.31 | Professional | None | $26.30 | $26.30 | $36.31 |
Lucent Health Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $389.05 | Professional | None | $269.15 | $389.05 | $389.05 |
Moda Health Setting Facility Modifier None Typical Low $15.14 Median $28.18 Typical High $53.70 | Facility | None | $15.14 | $28.18 | $53.70 |
Moda Health Setting Professional Modifier None Typical Low $22.91 Median $24.55 Typical High $34.67 | Professional | None | $22.91 | $24.55 | $34.67 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $81.28 | Professional | None | $33.88 | $33.88 | $81.28 |
Providence Setting Facility Modifier None Typical Low $22.39 Median $36.31 Typical High $53.70 | Facility | None | $22.39 | $36.31 | $53.70 |
Providence Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $36.31 | Professional | None | $26.30 | $26.30 | $36.31 |
United Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $63.10 | Facility | None | $53.70 | $53.70 | $63.10 |
United Setting Professional Modifier None Typical Low $17.78 Median $25.70 Typical High $33.11 | Professional | None | $17.78 | $25.70 | $33.11 |
Wellpoint Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $28.18 | Professional | None | $27.54 | $27.54 | $28.18 |
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 $11.48 Median $12.02 Typical High $15.14 | Professional | 52 · Reduced service | $11.48 | $12.02 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.90 Typical High $6.03 | Professional | 53 · Discontinued | $4.57 | $4.90 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $3.63 Typical High $4.47 | Professional | 55 · Aftercare only | $3.47 | $3.63 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.45 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.29 | $2.45 | $3.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $11.48 Median $12.02 Typical High $14.45 | Professional | 52 · Reduced service | $11.48 | $12.02 | $14.45 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.90 Typical High $5.75 | Professional | 53 · Discontinued | $4.57 | $4.90 | $5.75 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $3.63 Typical High $4.37 | Professional | 55 · Aftercare only | $3.47 | $3.63 | $4.37 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.45 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.29 | $2.45 | $2.88 |
Where Texas sits
The same service costs 2.1 times more in Montana than in Alabama. 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
$29.51
MT $54.95AL $26.30
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.