How much rates vary
Facilitymedian $105 · 10th to 90th $87 to $148Professionalmedian $102 · 10th to 90th $48 to $1,000
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 $102.33 Typical High $104.71 | Facility | None | $95.50 | $102.33 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $104.71 | Professional | None | $87.10 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $43.65 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $20.42 Typical High $20.89 | Professional | 53 · Discontinued | $17.38 | $20.42 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $15.14 Typical High $15.49 | Professional | 55 · Aftercare only | $13.18 | $15.14 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.23 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.71 | $10.23 | $10.47 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Lucent Health Setting Professional Modifier None Typical Low $660.69 Median $1,000.00 Typical High $1,000.00 | Professional | None | $660.69 | $1,000.00 | $1,000.00 |
Moda Health Setting Facility Modifier None Typical Low $87.10 Median $104.71 Typical High $151.36 | Facility | None | $87.10 | $104.71 | $151.36 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $95.50 Typical High $104.71 | Professional | None | $93.33 | $95.50 | $104.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $51.29 Typical High $53.70 | Professional | 52 · Reduced service | $43.65 | $51.29 | $53.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $20.42 Typical High $21.38 | Professional | 53 · Discontinued | $17.38 | $20.42 | $21.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $15.14 Typical High $15.85 | Professional | 55 · Aftercare only | $13.18 | $15.14 | $15.85 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.23 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.71 | $10.23 | $10.72 |
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 $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
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 $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
United Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $131.83 | Facility | None | $112.20 | $112.20 | $131.83 |
United Setting Professional Modifier None Typical Low $40.74 Median $60.26 Typical High $69.18 | Professional | None | $40.74 | $60.26 | $69.18 |
Wellpoint Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $131.83 | Professional | None | $123.03 | $131.83 | $131.83 |
4 more rates 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 PL · Progressive lenses Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | PL · Progressive lenses | $91.20 | $91.20 | $91.20 |
United Setting Professional Modifier CD · Dialysis lab test, bundled Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | CD · Dialysis lab test, bundled | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier CM · 80–99% impaired Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | CM · 80–99% impaired | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where Texas sits
The same service costs 2.6 times more in Hawaii than in Indiana. 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· 7th of 51
$102
HI $126IN $47.86
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.