How much rates vary
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 $20.89 Median $21.88 Typical High $22.39 | Facility | None | $20.89 | $21.88 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $20.89 Typical High $22.39 | Professional | None | $18.20 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.91 Median $10.96 Typical High $11.22 | Professional | 52 · Reduced service | $8.91 | $10.96 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $4.47 Typical High $4.47 | Professional | 53 · Discontinued | $3.55 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $3.31 Typical High $3.39 | Professional | 55 · Aftercare only | $2.69 | $3.31 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $2.19 Typical High $2.24 | Professional | 56 · Pre-op care only | $1.78 | $2.19 | $2.24 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Lucent Health Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $151.36 | Professional | None | $134.90 | $151.36 | $151.36 |
Moda Health Setting Facility Modifier None Typical Low $19.05 Median $22.39 Typical High $33.11 | Facility | None | $19.05 | $22.39 | $33.11 |
Moda Health Setting Professional Modifier None Typical Low $20.42 Median $20.89 Typical High $22.39 | Professional | None | $20.42 | $20.89 | $22.39 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $9.12 Median $10.96 Typical High $11.22 | Professional | 52 · Reduced service | $9.12 | $10.96 | $11.22 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $4.47 Typical High $4.57 | Professional | 53 · Discontinued | $3.72 | $4.47 | $4.57 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $3.31 Typical High $3.39 | Professional | 55 · Aftercare only | $2.75 | $3.31 | $3.39 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $2.19 Typical High $2.24 | Professional | 56 · Pre-op care only | $1.91 | $2.19 | $2.24 |
Molina Setting Professional Modifier None Typical Low $17.78 Median $19.05 Typical High $19.05 | Professional | None | $17.78 | $19.05 | $19.05 |
Oscar Health Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Providence Setting Facility Modifier None Typical Low $19.05 Median $26.92 Typical High $33.11 | Facility | None | $19.05 | $26.92 | $33.11 |
Providence Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
United Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $26.92 | Facility | None | $22.91 | $22.91 | $26.92 |
United Setting Professional Modifier None Typical Low $6.03 Median $12.30 Typical High $14.13 | Professional | None | $6.03 | $12.30 | $14.13 |
Wellpoint Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
1 more rate 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 BS Typical Low $7.08 Median $15.14 Typical High $15.14 | Professional | BS | $7.08 | $15.14 | $15.14 |
Where Texas sits
The same service costs 3.2 times more in Montana 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· 3rd of 51
$20.89
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.