How much rates vary
Facilitymedian $166 · 10th to 90th $49 to $302Professionalmedian $126 · 10th to 90th $34 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 $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $34.67 | Professional | None | $33.88 | $33.88 | $34.67 |
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 $33.88 Median $33.88 Typical High $48.98 | Facility | None | $33.88 | $33.88 | $48.98 |
Moda Health Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $37.15 | Professional | None | $33.88 | $33.88 | $37.15 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $33.88 Typical High $43.65 | Professional | None | $30.20 | $33.88 | $43.65 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $169.82 Typical High $302.00 | Facility | None | $50.12 | $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 $16.98 Median $16.98 Typical High $17.38 | Professional | 52 · Reduced service | $16.98 | $16.98 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $6.92 | Professional | 53 · Discontinued | $6.76 | $6.76 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $5.25 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $3.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $16.98 Typical High $17.38 | Professional | 52 · Reduced service | $16.98 | $16.98 | $17.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $6.92 | Professional | 53 · Discontinued | $6.76 | $6.76 | $6.92 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $5.25 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $5.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $3.47 |
Where Texas sits
The same service costs 4.2 times more in North Dakota than in Maryland. 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· 14th of 51
$126
ND $141MD $33.88
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.