How much rates vary
Facilitymedian $85 · 10th to 90th $72 to $126Professionalmedian $78 · 10th to 90th $39 to $977
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 $77.62 Median $83.18 Typical High $85.11 | Facility | None | $77.62 | $83.18 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $83.18 Typical High $87.10 | Professional | None | $75.86 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $41.69 Typical High $43.65 | Professional | 52 · Reduced service | $38.02 | $41.69 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $16.60 Typical High $17.78 | Professional | 53 · Discontinued | $15.14 | $16.60 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.59 Typical High $13.18 | Professional | 55 · Aftercare only | $11.48 | $12.59 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.32 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.59 | $8.32 | $8.71 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Lucent Health Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $977.24 | Professional | None | $630.96 | $977.24 | $977.24 |
Moda Health Setting Facility Modifier None Typical Low $72.44 Median $85.11 Typical High $125.89 | Facility | None | $72.44 | $85.11 | $125.89 |
Moda Health Setting Professional Modifier None Typical Low $75.86 Median $83.18 Typical High $87.10 | Professional | None | $75.86 | $83.18 | $87.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $41.69 Typical High $43.65 | Professional | 52 · Reduced service | $38.02 | $41.69 | $43.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $16.60 Typical High $17.78 | Professional | 53 · Discontinued | $15.14 | $16.60 | $17.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.59 Typical High $13.18 | Professional | 55 · Aftercare only | $11.48 | $12.59 | $13.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.32 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.59 | $8.32 | $8.71 |
Molina Setting Professional Modifier None Typical Low $43.65 Median $47.86 Typical High $47.86 | Professional | None | $43.65 | $47.86 | $47.86 |
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 $72.44 Median $102.33 Typical High $125.89 | Facility | None | $72.44 | $102.33 | $125.89 |
Providence Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $138.04 | Facility | None | $117.49 | $117.49 | $138.04 |
United Setting Professional Modifier None Typical Low $12.88 Median $50.12 Typical High $72.44 | Professional | None | $12.88 | $50.12 | $72.44 |
Wellpoint Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $138.04 | Professional | None | $102.33 | $138.04 | $138.04 |
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 Hawaii than in Ohio. 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
$77.62
HI $126OH $48.98
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.