How much rates vary
Facilitymedian $170 · 10th to 90th $135 to $302Professionalmedian $126 · 10th to 90th $126 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 $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $162.18 | Professional | None | $138.04 | $162.18 | $162.18 |
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 $162.18 Median $162.18 Typical High $234.42 | Facility | None | $162.18 | $162.18 | $234.42 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $165.96 | Professional | None | $138.04 | $162.18 | $165.96 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $162.18 | Professional | None | $30.20 | $30.20 | $162.18 |
Oscar Health Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $302.00 | Professional | None | $204.17 | $204.17 | $302.00 |
Providence Setting Facility Modifier None Typical Low $141.25 Median $169.82 Typical High $302.00 | Facility | None | $141.25 | $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 $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $69.18 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $69.18 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $32.36 Typical High $33.11 | Professional | 53 · Discontinued | $27.54 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $20.89 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $13.80 | $16.22 | $16.22 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $69.18 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $32.36 Typical High $33.11 | Professional | 53 · Discontinued | $27.54 | $32.36 | $33.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $20.89 | $24.55 | $24.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $13.80 | $16.22 | $16.22 |
Where Texas sits
The same service costs 2.3 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· 35th of 51
$126
ND $224NC $97.72
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.