How much rates vary
Facilitymedian $145 · 10th to 90th $100 to $407Professionalmedian $126 · 10th to 90th $100 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 $97.72 Median $100.00 Typical High $100.00 | Facility | None | $97.72 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $100.00 Typical High $100.00 | Professional | None | $97.72 | $100.00 | $100.00 |
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 $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 $100.00 Median $120.23 Typical High $141.25 | Facility | None | $100.00 | $120.23 | $141.25 |
Moda Health Setting Professional Modifier None Typical Low $97.72 Median $100.00 Typical High $114.82 | Professional | None | $97.72 | $100.00 | $114.82 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
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 $109.65 Median $144.54 Typical High $1,096.48 | Facility | None | $109.65 | $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 $47.86 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $47.86 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $19.50 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.79 Typical High $15.14 | Professional | 55 · Aftercare only | $14.45 | $14.79 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $9.77 | $10.00 | $10.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $47.86 | $50.12 | $50.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $19.50 | $19.95 | $19.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.79 Typical High $14.79 | Professional | 55 · Aftercare only | $14.45 | $14.79 | $14.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $9.77 | $10.00 | $10.00 |
Where Texas sits
The same service costs 1.9 times more in North Dakota than in Hawaii. 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· 15th of 51
$126
ND $182HI $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.