How much rates vary
Facilitymedian $148 · 10th to 90th $126 to $214Professionalmedian $148 · 10th to 90th $65 to $1,148
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 $138.04 Median $147.91 Typical High $147.91 | Facility | None | $138.04 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $147.91 | Professional | None | $123.03 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $72.44 Typical High $74.13 | Professional | 52 · Reduced service | $61.66 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $29.51 Typical High $30.20 | Professional | 53 · Discontinued | $24.55 | $29.51 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $21.88 Typical High $22.39 | Professional | 55 · Aftercare only | $18.62 | $21.88 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.30 | $14.79 | $14.79 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Lucent Health Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,148.15 | Professional | None | $891.25 | $1,148.15 | $1,148.15 |
Moda Health Setting Facility Modifier None Typical Low $125.89 Median $147.91 Typical High $218.78 | Facility | None | $125.89 | $147.91 | $218.78 |
Moda Health Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $147.91 | Professional | None | $125.89 | $147.91 | $147.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $72.44 Typical High $74.13 | Professional | 52 · Reduced service | $63.10 | $72.44 | $74.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $29.51 Typical High $30.20 | Professional | 53 · Discontinued | $25.12 | $29.51 | $30.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $21.88 Typical High $22.39 | Professional | 55 · Aftercare only | $19.05 | $21.88 | $22.39 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.59 | $14.79 | $14.79 |
Molina Setting Professional Modifier None Typical Low $77.62 Median $83.18 Typical High $83.18 | Professional | None | $77.62 | $83.18 | $83.18 |
Oscar Health Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $177.83 Typical High $218.78 | Facility | None | $125.89 | $177.83 | $218.78 |
Providence Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
United Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $181.97 | Facility | None | $154.88 | $154.88 | $181.97 |
United Setting Professional Modifier None Typical Low $54.95 Median $81.28 Typical High $95.50 | Professional | None | $54.95 | $81.28 | $95.50 |
Wellpoint Setting Professional Modifier None Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | None | $177.83 | $181.97 | $181.97 |
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 2.4 times more in Montana 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· 4th of 51
$148
MT $155IN $64.57
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.