How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,202 to $10,965Professionalmedian $5,754 · 10th to 90th $490 to $7,079
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $1,230.27 Median $3,890.45 Typical High $12,589.25 | Facility | None | $1,230.27 | $3,890.45 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $5,888.44 | Professional | None | $489.78 | $512.86 | $5,888.44 |
Christus Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,691.53 Typical High $5,128.61 | Facility | None | $794.33 | $2,691.53 | $5,128.61 |
Lucent Health Setting Professional Modifier None Typical Low $5,754.40 Median $7,079.46 Typical High $7,079.46 | Professional | None | $5,754.40 | $7,079.46 | $7,079.46 |
Moda Health Setting Facility Modifier None Typical Low $588.84 Median $3,467.37 Typical High $13,489.63 | Facility | None | $588.84 | $3,467.37 | $13,489.63 |
Moda Health Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $794.33 | Professional | None | $489.78 | $512.86 | $794.33 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $2,951.21 Typical High $11,748.98 | Facility | None | $660.69 | $2,951.21 | $11,748.98 |
Providence Setting Professional Modifier None Typical Low $416.87 Median $1,479.11 Typical High $1,479.11 | Professional | None | $416.87 | $1,479.11 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,549.93 | Facility | None | $1,698.24 | $4,570.88 | $9,549.93 |
United Setting Professional Modifier None Typical Low $416.87 Median $602.56 Typical High $912.01 | Professional | None | $416.87 | $602.56 | $912.01 |
Wellpoint Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
10 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $257.04 Typical High $269.15 | Professional | 52 · Reduced service | $245.47 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $102.33 Typical High $107.15 | Professional | 53 · Discontinued | $100.00 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $389.05 Typical High $398.11 | Professional | 54 · Surgery only | $371.54 | $389.05 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $77.62 Typical High $81.28 | Professional | 55 · Aftercare only | $74.13 | $77.62 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $53.70 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $53.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $257.04 Typical High $269.15 | Professional | 52 · Reduced service | $245.47 | $257.04 | $269.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $102.33 Typical High $107.15 | Professional | 53 · Discontinued | $100.00 | $102.33 | $107.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $389.05 Typical High $398.11 | Professional | 54 · Surgery only | $371.54 | $389.05 | $398.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $77.62 Typical High $81.28 | Professional | 55 · Aftercare only | $74.13 | $77.62 | $81.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $53.70 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $53.70 |
Where Texas sits
The same service costs 10.2 times more in Texas 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· 1st of 51
$4,074
TX $4,074NY $398
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.