How much rates vary
Facilitymedian $15,136 · 10th to 90th $1,288 to $38,905Professionalmedian $2,630 · 10th to 90th $380 to $3,020
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 $1,122.02 Median $4,073.80 Typical High $10,964.78 | Facility | None | $1,122.02 | $4,073.80 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $398.11 Typical High $5,754.40 | Professional | None | $380.19 | $398.11 | $5,754.40 |
Christus Setting Facility Modifier None Typical Low $22,908.68 Median $22,908.68 Typical High $22,908.68 | Facility | None | $22,908.68 | $22,908.68 | $22,908.68 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $21,877.62 Typical High $30,902.95 | Facility | None | $758.58 | $21,877.62 | $30,902.95 |
Lucent Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,630.27 | $3,019.95 | $3,019.95 |
Moda Health Setting Facility Modifier None Typical Low $398.11 Median $2,570.40 Typical High $8,511.38 | Facility | None | $398.11 | $2,570.40 | $8,511.38 |
Moda Health Setting Professional Modifier None Typical Low $380.19 Median $398.11 Typical High $426.58 | Professional | None | $380.19 | $398.11 | $426.58 |
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 $537.03 Median $21,877.62 Typical High $30,902.95 | Facility | None | $537.03 | $21,877.62 | $30,902.95 |
Providence Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
United Setting Facility Modifier None Typical Low $6,025.60 Median $19,054.61 Typical High $64,565.42 | Facility | None | $6,025.60 | $19,054.61 | $64,565.42 |
United Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $707.95 | Professional | None | $316.23 | $446.68 | $707.95 |
Wellpoint Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
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 $190.55 Median $199.53 Typical High $204.17 | Professional | 52 · Reduced service | $190.55 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $79.43 Typical High $83.18 | Professional | 53 · Discontinued | $75.86 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $295.12 Typical High $309.03 | Professional | 54 · Surgery only | $281.84 | $295.12 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $58.88 Typical High $61.66 | Professional | 55 · Aftercare only | $57.54 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $39.81 Typical High $40.74 | Professional | 56 · Pre-op care only | $38.02 | $39.81 | $40.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $199.53 Typical High $204.17 | Professional | 52 · Reduced service | $190.55 | $199.53 | $204.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $79.43 Typical High $83.18 | Professional | 53 · Discontinued | $75.86 | $79.43 | $83.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $295.12 Typical High $309.03 | Professional | 54 · Surgery only | $281.84 | $295.12 | $309.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $58.88 Typical High $61.66 | Professional | 55 · Aftercare only | $57.54 | $58.88 | $61.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $39.81 Typical High $40.74 | Professional | 56 · Pre-op care only | $38.02 | $39.81 | $40.74 |
Where Texas sits
The same service costs 57.5 times more in Arkansas 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· 15th of 51
$3,020
AR $17,783NY $309
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.