How much rates vary
Facilitymedian $74 · 10th to 90th $63 to $110Professionalmedian $72 · 10th to 90th $36 to $776
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 $69.18 Median $72.44 Typical High $74.13 | Facility | None | $69.18 | $72.44 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $72.44 Typical High $77.62 | Professional | None | $67.61 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $36.31 Typical High $38.90 | Professional | 52 · Reduced service | $33.88 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.79 Typical High $15.49 | Professional | 53 · Discontinued | $13.49 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.96 Typical High $11.48 | Professional | 55 · Aftercare only | $10.00 | $10.96 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.24 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.76 | $7.24 | $7.76 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Lucent Health Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $776.25 | Professional | None | $575.44 | $776.25 | $776.25 |
Moda Health Setting Facility Modifier None Typical Low $63.10 Median $74.13 Typical High $109.65 | Facility | None | $63.10 | $74.13 | $109.65 |
Moda Health Setting Professional Modifier None Typical Low $67.61 Median $72.44 Typical High $77.62 | Professional | None | $67.61 | $72.44 | $77.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $36.31 Typical High $38.90 | Professional | 52 · Reduced service | $33.88 | $36.31 | $38.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.79 Typical High $15.49 | Professional | 53 · Discontinued | $13.49 | $14.79 | $15.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.96 Typical High $11.48 | Professional | 55 · Aftercare only | $10.00 | $10.96 | $11.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.24 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.76 | $7.24 | $7.76 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $41.69 Typical High $41.69 | Professional | None | $38.90 | $41.69 | $41.69 |
Oscar Health Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $89.13 | Professional | None | $19.95 | $19.95 | $89.13 |
Providence Setting Facility Modifier None Typical Low $63.10 Median $89.13 Typical High $109.65 | Facility | None | $63.10 | $89.13 | $109.65 |
Providence Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $120.23 | Facility | None | $102.33 | $102.33 | $120.23 |
United Setting Professional Modifier None Typical Low $10.96 Median $36.31 Typical High $63.10 | Professional | None | $10.96 | $36.31 | $63.10 |
Wellpoint Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $120.23 | Professional | None | $89.13 | $120.23 | $120.23 |
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 Hawaii 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· 24th of 51
$72.44
HI $135NY $41.69
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.