How much rates vary
Facilitymedian $166 · 10th to 90th $69 to $302Professionalmedian $126 · 10th to 90th $69 to $1,096
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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $70.79 | Professional | None | $69.18 | $69.18 | $70.79 |
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 $660.69 Median $1,096.48 Typical High $1,096.48 | Professional | None | $660.69 | $1,096.48 | $1,096.48 |
Moda Health Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $97.72 | Facility | None | $69.18 | $69.18 | $97.72 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $75.86 | Professional | None | $69.18 | $69.18 | $75.86 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $67.61 Typical High $87.10 | Professional | None | $30.20 | $67.61 | $87.10 |
Providence Setting Facility Modifier None Typical Low $97.72 Median $169.82 Typical High $302.00 | Facility | None | $97.72 | $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 $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
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 $33.88 Median $33.88 Typical High $35.48 | Professional | 52 · Reduced service | $33.88 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $14.13 | Professional | 53 · Discontinued | $13.80 | $13.80 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $10.47 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $7.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $33.88 Typical High $35.48 | Professional | 52 · Reduced service | $33.88 | $33.88 | $35.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $14.13 | Professional | 53 · Discontinued | $13.80 | $13.80 | $14.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $10.47 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $10.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $7.08 |
Where Texas sits
The same service costs 2.7 times more in North Dakota than in North Carolina. 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· 17th of 51
$126
ND $141NC $52.48
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.