How much rates vary
Facilitymedian $288 · 10th to 90th $245 to $417Professionalmedian $282 · 10th to 90th $132 to $2,042
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 $263.03 Median $281.84 Typical High $288.40 | Facility | None | $263.03 | $281.84 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $288.40 | Professional | None | $245.47 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $141.25 Typical High $144.54 | Professional | 52 · Reduced service | $123.03 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $56.23 Typical High $57.54 | Professional | 53 · Discontinued | $48.98 | $56.23 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $42.66 Typical High $43.65 | Professional | 55 · Aftercare only | $37.15 | $42.66 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $28.18 Typical High $28.84 | Professional | 56 · Pre-op care only | $24.55 | $28.18 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Lucent Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,737.80 | $2,041.74 | $2,041.74 |
Moda Health Setting Facility Modifier None Typical Low $245.47 Median $288.40 Typical High $426.58 | Facility | None | $245.47 | $288.40 | $426.58 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $288.40 | Professional | None | $245.47 | $281.84 | $288.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $141.25 Typical High $144.54 | Professional | 52 · Reduced service | $123.03 | $141.25 | $144.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $56.23 Typical High $57.54 | Professional | 53 · Discontinued | $48.98 | $56.23 | $57.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $42.66 Typical High $43.65 | Professional | 55 · Aftercare only | $37.15 | $42.66 | $43.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $28.18 Typical High $28.84 | Professional | 56 · Pre-op care only | $24.55 | $28.18 | $28.84 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $162.18 | Professional | None | $147.91 | $162.18 | $162.18 |
Oscar Health Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Providence Setting Facility Modifier None Typical Low $245.47 Median $346.74 Typical High $426.58 | Facility | None | $245.47 | $346.74 | $426.58 |
Providence Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
United Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $363.08 | Facility | None | $309.03 | $309.03 | $363.08 |
United Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $190.55 | Professional | None | $112.20 | $165.96 | $190.55 |
Wellpoint Setting Professional Modifier None Typical Low $346.74 Median $363.08 Typical High $363.08 | Professional | None | $346.74 | $363.08 | $363.08 |
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 3.2 times more in Minnesota 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· 6th of 51
$282
MN $363NY $115
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.