How much rates vary
Facilitymedian $63 · 10th to 90th $54 to $93Professionalmedian $58 · 10th to 90th $33 to $708
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 $57.54 Median $61.66 Typical High $63.10 | Facility | None | $57.54 | $61.66 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $64.57 | Professional | None | $56.23 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $30.90 Typical High $32.36 | Professional | 52 · Reduced service | $28.18 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $12.30 Typical High $12.88 | Professional | 53 · Discontinued | $11.22 | $12.30 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $9.33 Typical High $9.77 | Professional | 55 · Aftercare only | $8.51 | $9.33 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.17 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.62 | $6.17 | $6.46 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Lucent Health Setting Professional Modifier None Typical Low $457.09 Median $707.95 Typical High $707.95 | Professional | None | $457.09 | $707.95 | $707.95 |
Moda Health Setting Facility Modifier None Typical Low $52.48 Median $63.10 Typical High $93.33 | Facility | None | $52.48 | $63.10 | $93.33 |
Moda Health Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $64.57 | Professional | None | $56.23 | $61.66 | $64.57 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $30.90 Typical High $32.36 | Professional | 52 · Reduced service | $28.18 | $30.90 | $32.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $12.30 Typical High $12.88 | Professional | 53 · Discontinued | $11.22 | $12.30 | $12.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $9.33 Typical High $9.77 | Professional | 55 · Aftercare only | $8.51 | $9.33 | $9.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.17 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.62 | $6.17 | $6.46 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $35.48 Typical High $35.48 | Professional | None | $32.36 | $35.48 | $35.48 |
Oscar Health Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Providence Setting Facility Modifier None Typical Low $52.48 Median $75.86 Typical High $93.33 | Facility | None | $52.48 | $75.86 | $93.33 |
Providence Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
United Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $95.50 | Facility | None | $81.28 | $81.28 | $95.50 |
United Setting Professional Modifier None Typical Low $12.88 Median $34.67 Typical High $50.12 | Professional | None | $12.88 | $34.67 | $50.12 |
Wellpoint Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $95.50 | Professional | None | $75.86 | $95.50 | $95.50 |
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 2.9 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· 23rd of 51
$57.54
MT $100NE $34.67
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.