How much rates vary
Facilitymedian $66 · 10th to 90th $47 to $132Professionalmedian $65 · 10th to 90th $49 to $933
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 $57.54 Median $57.54 Typical High $60.26 | Facility | None | $57.54 | $57.54 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $72.44 | Professional | None | $56.23 | $60.26 | $72.44 |
Christus Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
Lucent Health Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $933.25 | Professional | None | $691.83 | $933.25 | $933.25 |
Moda Health Setting Facility Modifier None Typical Low $33.11 Median $72.44 Typical High $131.83 | Facility | None | $33.11 | $72.44 | $131.83 |
Moda Health Setting Professional Modifier None Typical Low $53.70 Median $60.26 Typical High $91.20 | Professional | None | $53.70 | $60.26 | $91.20 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $81.28 | Professional | None | $69.18 | $69.18 | $81.28 |
Providence Setting Facility Modifier None Typical Low $54.95 Median $66.07 Typical High $131.83 | Facility | None | $54.95 | $66.07 | $131.83 |
Providence Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
United Setting Facility Modifier None Typical Low $46.77 Median $61.66 Typical High $117.49 | Facility | None | $46.77 | $61.66 | $117.49 |
United Setting Professional Modifier None Typical Low $38.90 Median $56.23 Typical High $72.44 | Professional | None | $38.90 | $56.23 | $72.44 |
Wellpoint Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
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 $28.18 Median $30.20 Typical High $36.31 | Professional | 52 · Reduced service | $28.18 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $12.02 Typical High $14.79 | Professional | 53 · Discontinued | $11.22 | $12.02 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.91 Typical High $10.96 | Professional | 55 · Aftercare only | $8.51 | $8.91 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.03 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.62 | $6.03 | $7.41 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $29.51 Typical High $35.48 | Professional | 52 · Reduced service | $27.54 | $29.51 | $35.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $11.75 Typical High $14.45 | Professional | 53 · Discontinued | $10.96 | $11.75 | $14.45 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.71 Typical High $10.72 | Professional | 55 · Aftercare only | $8.32 | $8.71 | $10.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.89 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.50 | $5.89 | $7.08 |
Where Texas sits
The same service costs 2.7 times more in Hawaii 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· 28th of 51
$64.57
HI $132DE $48.98
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.