How much rates vary
Facilitymedian $102 · 10th to 90th $87 to $148Professionalmedian $95 · 10th to 90th $45 to $832
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 $95.50 Median $100.00 Typical High $102.33 | Facility | None | $95.50 | $100.00 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $102.33 | Professional | None | $91.20 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $50.12 Typical High $51.29 | Professional | 52 · Reduced service | $45.71 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $18.20 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.14 Typical High $15.49 | Professional | 55 · Aftercare only | $13.80 | $15.14 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.00 Typical High $10.23 | Professional | 56 · Pre-op care only | $9.12 | $10.00 | $10.23 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Lucent Health Setting Professional Modifier None Typical Low $794.33 Median $831.76 Typical High $831.76 | Professional | None | $794.33 | $831.76 | $831.76 |
Moda Health Setting Facility Modifier None Typical Low $87.10 Median $102.33 Typical High $151.36 | Facility | None | $87.10 | $102.33 | $151.36 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $107.15 | Professional | None | $93.33 | $100.00 | $107.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $50.12 Typical High $51.29 | Professional | 52 · Reduced service | $46.77 | $50.12 | $51.29 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $18.62 | $20.42 | $20.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $15.14 Typical High $15.49 | Professional | 55 · Aftercare only | $13.80 | $15.14 | $15.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.00 Typical High $10.23 | Professional | 56 · Pre-op care only | $9.33 | $10.00 | $10.23 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $57.54 Typical High $57.54 | Professional | None | $53.70 | $57.54 | $57.54 |
Oscar Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $123.03 Typical High $151.36 | Facility | None | $87.10 | $123.03 | $151.36 |
Providence Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
United Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $147.91 | Facility | None | $123.03 | $123.03 | $147.91 |
United Setting Professional Modifier None Typical Low $15.14 Median $53.70 Typical High $77.62 | Professional | None | $15.14 | $53.70 | $77.62 |
Wellpoint Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $147.91 | Professional | None | $123.03 | $147.91 | $147.91 |
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 4.2 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· 13th of 51
$95.50
HI $191NY $45.71
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.