How much rates vary
Facilitymedian $195 · 10th to 90th $166 to $288Professionalmedian $195 · 10th to 90th $107 to $2,239
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 $181.97 Median $194.98 Typical High $194.98 | Facility | None | $181.97 | $194.98 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $181.97 Typical High $199.53 | Professional | None | $177.83 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $95.50 Typical High $102.33 | Professional | 52 · Reduced service | $89.13 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.90 Typical High $40.74 | Professional | 53 · Discontinued | $35.48 | $38.90 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $28.84 Typical High $30.20 | Professional | 55 · Aftercare only | $26.30 | $28.84 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.50 Typical High $20.42 | Professional | 56 · Pre-op care only | $17.78 | $19.50 | $20.42 |
Baylor Scott & White Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $173.78 | Professional | None | $128.82 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Lucent Health Setting Professional Modifier None Typical Low $1,412.54 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,412.54 | $2,238.72 | $2,238.72 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $194.98 Typical High $288.40 | Facility | None | $165.96 | $194.98 | $288.40 |
Moda Health Setting Professional Modifier None Typical Low $177.83 Median $181.97 Typical High $204.17 | Professional | None | $177.83 | $181.97 | $204.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $95.50 Typical High $102.33 | Professional | 52 · Reduced service | $89.13 | $95.50 | $102.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.90 Typical High $40.74 | Professional | 53 · Discontinued | $35.48 | $38.90 | $40.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $28.84 Typical High $30.20 | Professional | 55 · Aftercare only | $26.30 | $28.84 | $30.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.50 Typical High $20.42 | Professional | 56 · Pre-op care only | $17.78 | $19.50 | $20.42 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $109.65 Typical High $109.65 | Professional | None | $102.33 | $109.65 | $109.65 |
Oscar Health Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Providence Setting Facility Modifier None Typical Low $165.96 Median $234.42 Typical High $288.40 | Facility | None | $165.96 | $234.42 | $288.40 |
Providence Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
United Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $295.12 | Facility | None | $251.19 | $251.19 | $295.12 |
United Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $154.88 | Professional | None | $91.20 | $134.90 | $154.88 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $295.12 Typical High $295.12 | Professional | None | $234.42 | $295.12 | $295.12 |
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 2.8 times more in Minnesota than in Utah. 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· 14th of 51
$195
MN $295UT $107
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.