How much rates vary
Facilitymedian $1,820 · 10th to 90th $631 to $5,248Professionalmedian $2,512 · 10th to 90th $389 to $3,090
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 $851.14 Median $2,754.23 Typical High $6,918.31 | Facility | None | $851.14 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $407.38 Typical High $3,311.31 | Professional | None | $389.05 | $407.38 | $3,311.31 |
Christus Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,479.11 Typical High $3,981.07 | Facility | None | $794.33 | $1,479.11 | $3,981.07 |
Lucent Health Setting Professional Modifier None Typical Low $2,511.89 Median $3,090.30 Typical High $3,090.30 | Professional | None | $2,511.89 | $3,090.30 | $3,090.30 |
Moda Health Setting Facility Modifier None Typical Low $407.38 Median $2,238.72 Typical High $6,025.60 | Facility | None | $407.38 | $2,238.72 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $389.05 Median $407.38 Typical High $446.68 | Professional | None | $389.05 | $407.38 | $446.68 |
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 $630.96 Median $1,621.81 Typical High $10,000.00 | Facility | None | $630.96 | $1,621.81 | $10,000.00 |
Providence Setting Professional Modifier None Typical Low $302.00 Median $602.56 Typical High $602.56 | Professional | None | $302.00 | $602.56 | $602.56 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $776.25 | Professional | None | $346.74 | $489.78 | $776.25 |
Wellpoint Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
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 $194.98 Median $204.17 Typical High $213.80 | Professional | 52 · Reduced service | $194.98 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $81.28 Typical High $85.11 | Professional | 53 · Discontinued | $77.62 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $302.00 Typical High $316.23 | Professional | 54 · Surgery only | $295.12 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $63.10 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $42.66 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $204.17 Typical High $213.80 | Professional | 52 · Reduced service | $194.98 | $204.17 | $213.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $81.28 Typical High $85.11 | Professional | 53 · Discontinued | $77.62 | $81.28 | $85.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $302.00 Typical High $316.23 | Professional | 54 · Surgery only | $295.12 | $302.00 | $316.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $63.10 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $63.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $42.66 |
Where Texas sits
The same service costs 8.1 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
$2,291
TX $2,291NY $282
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.