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 $2.51 Median $2.51 Typical High $2.51 | Facility | None | $2.51 | $2.51 | $2.51 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.57 | Professional | None | $2.51 | $2.51 | $2.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.26 Median $1.26 Typical High $1.29 | Professional | 52 · Reduced service | $1.26 | $1.26 | $1.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $0.37 Typical High $0.38 | Professional | 55 · Aftercare only | $0.37 | $0.37 | $0.38 |
Christus Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $169.82 Typical High $316.23 | Facility | None | $125.89 | $169.82 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Lucent Health Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Professional | None | $5,370.32 | $5,370.32 | $5,370.32 |
Moda Health Setting Facility Modifier None Typical Low $2.51 Median $2.51 Typical High $3.55 | Facility | None | $2.51 | $2.51 | $3.55 |
Moda Health Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.75 | Professional | None | $2.51 | $2.51 | $2.75 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1.26 Median $1.26 Typical High $1.29 | Professional | 52 · Reduced service | $1.26 | $1.26 | $1.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $0.37 Typical High $0.38 | Professional | 55 · Aftercare only | $0.37 | $0.37 | $0.38 |
Molina Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $30.20 | Professional | None | $2.45 | $2.45 | $30.20 |
Providence Setting Facility Modifier None Typical Low $3.63 Median $169.82 Typical High $302.00 | Facility | None | $3.63 | $169.82 | $302.00 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Wellpoint Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
4 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 53 · Discontinued Typical Low $0.50 Median $0.50 Typical High $0.51 | Professional | 53 · Discontinued | $0.50 | $0.50 | $0.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.25 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.25 | $0.25 | $0.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.50 Typical High $0.51 | Professional | 53 · Discontinued | $0.50 | $0.50 | $0.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.25 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.25 | $0.25 | $0.26 |
Where Texas sits
The same service costs 50.1 times more in Massachusetts than in Indiana. 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· 7th of 51
$126
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.