How much rates vary
Facilitymedian $81 · 10th to 90th $69 to $117Professionalmedian $74 · 10th to 90th $32 to $741
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 $74.13 Median $79.43 Typical High $81.28 | Facility | None | $74.13 | $79.43 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $81.28 | Professional | None | $72.44 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $39.81 Typical High $40.74 | Professional | 52 · Reduced service | $35.48 | $39.81 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $15.85 Typical High $16.22 | Professional | 53 · Discontinued | $14.45 | $15.85 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $12.02 Typical High $12.30 | Professional | 55 · Aftercare only | $10.72 | $12.02 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.94 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.24 | $7.94 | $8.13 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Lucent Health Setting Professional Modifier None Typical Low $489.78 Median $741.31 Typical High $741.31 | Professional | None | $489.78 | $741.31 | $741.31 |
Moda Health Setting Facility Modifier None Typical Low $69.18 Median $81.28 Typical High $120.23 | Facility | None | $69.18 | $81.28 | $120.23 |
Moda Health Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $81.28 | Professional | None | $72.44 | $79.43 | $81.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $39.81 Typical High $40.74 | Professional | 52 · Reduced service | $36.31 | $39.81 | $40.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $15.85 Typical High $16.22 | Professional | 53 · Discontinued | $14.45 | $15.85 | $16.22 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $12.02 Typical High $12.30 | Professional | 55 · Aftercare only | $10.96 | $12.02 | $12.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.94 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.24 | $7.94 | $8.13 |
Molina Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $45.71 | Professional | None | $41.69 | $45.71 | $45.71 |
Oscar Health Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $97.72 | Professional | None | $19.95 | $19.95 | $97.72 |
Providence Setting Facility Modifier None Typical Low $69.18 Median $97.72 Typical High $120.23 | Facility | None | $69.18 | $97.72 | $120.23 |
Providence Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $102.33 | Facility | None | $87.10 | $87.10 | $102.33 |
United Setting Professional Modifier None Typical Low $10.96 Median $32.36 Typical High $53.70 | Professional | None | $10.96 | $32.36 | $53.70 |
Wellpoint Setting Professional Modifier None Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | None | $97.72 | $102.33 | $102.33 |
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 2.6 times more in Montana than in Nebraska. 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· 8th of 51
$74.13
MT $97.72NE $37.15
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.