How much rates vary
Facilitymedian $145 · 10th to 90th $87 to $407Professionalmedian $126 · 10th to 90th $89 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 $87.10 Median $87.10 Typical High $89.13 | Facility | None | $87.10 | $87.10 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $91.20 | Professional | None | $87.10 | $87.10 | $91.20 |
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 $245.47 Typical High $407.38 | Facility | None | $125.89 | $245.47 | $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 $87.10 Median $87.10 Typical High $125.89 | Facility | None | $87.10 | $87.10 | $125.89 |
Moda Health Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $97.72 | Professional | None | $87.10 | $87.10 | $97.72 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $131.83 | Professional | None | $79.43 | $79.43 | $131.83 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $144.54 Typical High $1,096.48 | Facility | None | $87.10 | $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 $43.65 Median $43.65 Typical High $45.71 | Professional | 52 · Reduced service | $43.65 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $18.20 | Professional | 53 · Discontinued | $17.78 | $17.78 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $13.49 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $9.12 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $9.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $43.65 Typical High $45.71 | Professional | 52 · Reduced service | $43.65 | $43.65 | $45.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $18.20 | Professional | 53 · Discontinued | $17.78 | $17.78 | $18.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $13.49 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $13.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $9.12 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $9.12 |
Where Texas sits
The same service costs 1.9 times more in Alaska than in New York. 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· 11th of 51
$126
AK $162NY $87.10
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.