How much rates vary
Facilitymedian $54 · 10th to 90th $30 to $145Professionalmedian $126 · 10th to 90th $20 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 $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $20.42 | Professional | None | $19.95 | $19.95 | $20.42 |
Christus Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $239.88 Typical High $407.38 | Facility | None | $125.89 | $239.88 | $407.38 |
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 $19.95 Median $19.95 Typical High $28.84 | Facility | None | $19.95 | $19.95 | $28.84 |
Moda Health Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $21.88 | Professional | None | $19.95 | $19.95 | $21.88 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $19.95 Median $144.54 Typical High $1,096.48 | Facility | None | $19.95 | $144.54 | $1,096.48 |
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 $10.00 Median $10.00 Typical High $10.23 | Professional | 52 · Reduced service | $10.00 | $10.00 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $3.98 Typical High $4.07 | Professional | 53 · Discontinued | $3.98 | $3.98 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $3.09 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.00 Typical High $2.04 | Professional | 56 · Pre-op care only | $2.00 | $2.00 | $2.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.00 Median $10.00 Typical High $10.23 | Professional | 52 · Reduced service | $10.00 | $10.00 | $10.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $3.98 Typical High $4.07 | Professional | 53 · Discontinued | $3.98 | $3.98 | $4.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $3.09 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $3.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.00 Typical High $2.04 | Professional | 56 · Pre-op care only | $2.00 | $2.00 | $2.04 |
Where Texas sits
The same service costs 6.3 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· 17th of 51
$126
MA $126IN $19.95
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.