How much rates vary
Facilitymedian $240 · 10th to 90th $204 to $347Professionalmedian $234 · 10th to 90th $105 to $2,188
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 $218.78 Median $234.42 Typical High $239.88 | Facility | None | $218.78 | $234.42 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $218.78 Typical High $239.88 | Professional | None | $204.17 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $117.49 Typical High $120.23 | Professional | 52 · Reduced service | $89.13 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $46.77 Typical High $47.86 | Professional | 53 · Discontinued | $36.31 | $46.77 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $35.48 Typical High $36.31 | Professional | 55 · Aftercare only | $26.92 | $35.48 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $23.44 Typical High $23.99 | Professional | 56 · Pre-op care only | $18.20 | $23.44 | $23.99 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Lucent Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,659.59 | $2,187.76 | $2,187.76 |
Moda Health Setting Facility Modifier None Typical Low $204.17 Median $239.88 Typical High $354.81 | Facility | None | $204.17 | $239.88 | $354.81 |
Moda Health Setting Professional Modifier None Typical Low $213.80 Median $218.78 Typical High $239.88 | Professional | None | $213.80 | $218.78 | $239.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $117.49 Typical High $120.23 | Professional | 52 · Reduced service | $102.33 | $117.49 | $120.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $46.77 Typical High $47.86 | Professional | 53 · Discontinued | $40.74 | $46.77 | $47.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $35.48 Typical High $36.31 | Professional | 55 · Aftercare only | $30.20 | $35.48 | $36.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $23.44 Typical High $23.99 | Professional | 56 · Pre-op care only | $20.42 | $23.44 | $23.99 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $134.90 | Professional | None | $123.03 | $134.90 | $134.90 |
Oscar Health Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Providence Setting Facility Modifier None Typical Low $204.17 Median $288.40 Typical High $354.81 | Facility | None | $204.17 | $288.40 | $354.81 |
Providence Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $288.40 | Facility | None | $245.47 | $245.47 | $288.40 |
United Setting Professional Modifier None Typical Low $89.13 Median $131.83 Typical High $151.36 | Professional | None | $89.13 | $131.83 | $151.36 |
Wellpoint Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
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 3.3 times more in Alaska 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
$234
AK $347IN $105
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.