How much rates vary
Facilitymedian $74 · 10th to 90th $56 to $135Professionalmedian $71 · 10th to 90th $54 to $1,122
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 $58.88 Median $58.88 Typical High $61.66 | Facility | None | $58.88 | $58.88 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $61.66 Typical High $75.86 | Professional | None | $57.54 | $61.66 | $75.86 |
Christus Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $74.13 | Professional | None | $53.70 | $53.70 | $74.13 |
Lucent Health Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,122.02 | Professional | None | $794.33 | $1,122.02 | $1,122.02 |
Moda Health Setting Facility Modifier None Typical Low $38.02 Median $74.13 Typical High $134.90 | Facility | None | $38.02 | $74.13 | $134.90 |
Moda Health Setting Professional Modifier None Typical Low $57.54 Median $61.66 Typical High $102.33 | Professional | None | $57.54 | $61.66 | $102.33 |
Molina Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $81.28 | Professional | None | $66.07 | $66.07 | $81.28 |
Providence Setting Facility Modifier None Typical Low $56.23 Median $74.13 Typical High $134.90 | Facility | None | $56.23 | $74.13 | $134.90 |
Providence Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $74.13 | Professional | None | $53.70 | $53.70 | $74.13 |
United Setting Facility Modifier None Typical Low $77.62 Median $79.43 Typical High $134.90 | Facility | None | $77.62 | $79.43 | $134.90 |
United Setting Professional Modifier None Typical Low $44.67 Median $64.57 Typical High $83.18 | Professional | None | $44.67 | $64.57 | $83.18 |
Wellpoint Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $70.79 | Professional | None | $69.18 | $69.18 | $70.79 |
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 $28.84 Median $30.90 Typical High $38.02 | Professional | 52 · Reduced service | $28.84 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.30 Typical High $15.14 | Professional | 53 · Discontinued | $11.48 | $12.30 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $9.12 Typical High $11.48 | Professional | 55 · Aftercare only | $8.71 | $9.12 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.17 Typical High $7.59 | Professional | 56 · Pre-op care only | $5.75 | $6.17 | $7.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $30.90 Typical High $37.15 | Professional | 52 · Reduced service | $28.84 | $30.90 | $37.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.30 Typical High $14.79 | Professional | 53 · Discontinued | $11.48 | $12.30 | $14.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $9.12 Typical High $10.96 | Professional | 55 · Aftercare only | $8.71 | $9.12 | $10.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.17 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.75 | $6.17 | $7.41 |
Where Texas sits
The same service costs 3.1 times more in Hawaii than in Florida. 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
$72.44
HI $170FL $54.95
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.