How much rates vary
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 $58.88 Typical High $138.04 | Facility | None | $57.54 | $58.88 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $58.88 Typical High $60.26 | Professional | None | $57.54 | $58.88 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $107.15 Typical High $194.98 | Facility | None | $61.66 | $107.15 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Lucent Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Moda Health Setting Facility Modifier None Typical Low $57.54 Median $77.62 Typical High $102.33 | Facility | None | $57.54 | $77.62 | $102.33 |
Moda Health Setting Professional Modifier None Typical Low $57.54 Median $58.88 Typical High $58.88 | Professional | None | $57.54 | $58.88 | $58.88 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $54.95 Typical High $60.26 | Professional | None | $30.20 | $54.95 | $60.26 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $93.33 Typical High $524.81 | Facility | None | $61.66 | $93.33 | $524.81 |
Providence Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $61.66 | Professional | None | $60.26 | $60.26 | $61.66 |
Wellpoint Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
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 $29.51 Typical High $30.20 | Professional | 52 · Reduced service | $28.84 | $29.51 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.75 Typical High $12.02 | Professional | 53 · Discontinued | $11.48 | $11.75 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $8.71 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.89 Typical High $6.03 | Professional | 56 · Pre-op care only | $5.75 | $5.89 | $6.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $28.84 | $29.51 | $29.51 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $11.48 | $11.75 | $11.75 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $8.71 | $8.91 | $8.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.89 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.75 | $5.89 | $5.89 |
Where Texas sits
The same service costs 1.6 times more in Alaska than in Hawaii. 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· 40th of 51
$61.66
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.