How much rates vary
Facilitymedian $35 · 10th to 90th $22 to $41Professionalmedian $22 · 10th to 90th $14 to $269
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 $21.88 Median $21.88 Typical High $23.99 | Facility | None | $21.88 | $21.88 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $21.88 Typical High $28.84 | Professional | None | $20.42 | $21.88 | $28.84 |
Ambetter Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Lucent Health Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $269.15 | Professional | None | $257.04 | $257.04 | $269.15 |
Moda Health Setting Facility Modifier None Typical Low $21.88 Median $34.67 Typical High $42.66 | Facility | None | $21.88 | $34.67 | $42.66 |
Moda Health Setting Professional Modifier None Typical Low $20.42 Median $21.88 Typical High $29.51 | Professional | None | $20.42 | $21.88 | $29.51 |
Oscar Health Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Providence Setting Facility Modifier None Typical Low $21.88 Median $34.67 Typical High $40.74 | Facility | None | $21.88 | $34.67 | $40.74 |
Providence Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
United Setting Professional Modifier None Typical Low $12.02 Median $15.14 Typical High $22.91 | Professional | None | $12.02 | $15.14 | $22.91 |
Wellpoint Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
10 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 $10.23 Median $10.96 Typical High $14.13 | Professional | 52 · Reduced service | $10.23 | $10.96 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.47 Typical High $5.62 | Professional | 53 · Discontinued | $4.07 | $4.47 | $5.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.14 Median $16.60 Typical High $21.38 | Professional | 54 · Surgery only | $15.14 | $16.60 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.31 Typical High $4.27 | Professional | 55 · Aftercare only | $3.02 | $3.31 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.19 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.04 | $2.19 | $2.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.23 Median $10.96 Typical High $13.49 | Professional | 52 · Reduced service | $10.23 | $10.96 | $13.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.47 Typical High $5.37 | Professional | 53 · Discontinued | $4.07 | $4.47 | $5.37 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $15.14 Median $16.60 Typical High $20.42 | Professional | 54 · Surgery only | $15.14 | $16.60 | $20.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.31 Typical High $4.07 | Professional | 55 · Aftercare only | $3.02 | $3.31 | $4.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.19 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.04 | $2.19 | $2.69 |
Where Texas sits
The same service costs 2.8 times more in Hawaii than in New York. 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· 26th of 51
$21.88
HI $37.15NY $13.49
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.