How much rates vary
Facilitymedian $37 · 10th to 90th $32 to $55Professionalmedian $34 · 10th to 90th $20 to $417
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $36.31 Typical High $37.15 | Facility | None | $33.88 | $36.31 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.88 Typical High $37.15 | Professional | None | $33.11 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.60 Median $18.20 Typical High $19.05 | Professional | 52 · Reduced service | $16.60 | $18.20 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $7.24 Typical High $7.59 | Professional | 53 · Discontinued | $6.61 | $7.24 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.50 Typical High $5.75 | Professional | 55 · Aftercare only | $5.01 | $5.50 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.63 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.31 | $3.63 | $3.80 |
Ambetter Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
Baylor Scott & White Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $44.67 | Professional | None | $33.11 | $33.11 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Lucent Health Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $416.87 | Professional | None | $269.15 | $416.87 | $416.87 |
Moda Health Setting Facility Modifier None Typical Low $31.62 Median $37.15 Typical High $54.95 | Facility | None | $31.62 | $37.15 | $54.95 |
Moda Health Setting Professional Modifier None Typical Low $33.11 Median $33.88 Typical High $38.02 | Professional | None | $33.11 | $33.88 | $38.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.60 Median $18.20 Typical High $19.05 | Professional | 52 · Reduced service | $16.60 | $18.20 | $19.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $7.24 Typical High $7.59 | Professional | 53 · Discontinued | $6.61 | $7.24 | $7.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.50 Typical High $5.75 | Professional | 55 · Aftercare only | $5.01 | $5.50 | $5.75 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.63 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.31 | $3.63 | $3.80 |
Molina Setting Professional Modifier None Typical Low $19.05 Median $20.89 Typical High $20.89 | Professional | None | $19.05 | $20.89 | $20.89 |
Oscar Health Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $44.67 | Professional | None | $19.95 | $19.95 | $44.67 |
Providence Setting Facility Modifier None Typical Low $31.62 Median $44.67 Typical High $54.95 | Facility | None | $31.62 | $44.67 | $54.95 |
Providence Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
United Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $54.95 | Facility | None | $46.77 | $46.77 | $54.95 |
United Setting Professional Modifier None Typical Low $10.96 Median $22.91 Typical High $29.51 | Professional | None | $10.96 | $22.91 | $29.51 |
Wellpoint Setting Professional Modifier None Typical Low $44.67 Median $54.95 Typical High $54.95 | Professional | None | $44.67 | $54.95 | $54.95 |
1 more rate 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 |
|---|---|---|---|---|---|
Oscar Health Setting Professional Modifier GX · Voluntary liability notice Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | GX · Voluntary liability notice | $12.59 | $12.59 | $12.59 |
Where Texas sits
The same service costs 3.2 times more in Montana 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· 21st of 51
$33.88
MT $64.57IN $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.