How much rates vary
Facilitymedian $3,631 · 10th to 90th $977 to $10,000Professionalmedian $1,148 · 10th to 90th $288 to $2,951
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 $977.24 Median $3,311.31 Typical High $9,120.11 | Facility | None | $977.24 | $3,311.31 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $371.54 Typical High $794.33 | Professional | None | $363.08 | $371.54 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,479.11 Typical High $2,691.53 | Facility | None | $537.03 | $1,479.11 | $2,691.53 |
Lucent Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,398.83 | $2,951.21 | $2,951.21 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $3,090.30 Typical High $6,918.31 | Facility | None | $645.65 | $3,090.30 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $363.08 Median $371.54 Typical High $389.05 | Professional | None | $363.08 | $371.54 | $389.05 |
Providence Setting Facility Modifier None Typical Low $478.63 Median $954.99 Typical High $2,691.53 | Facility | None | $478.63 | $954.99 | $2,691.53 |
United Setting Facility Modifier None Typical Low $2,089.30 Median $5,248.07 Typical High $11,748.98 | Facility | None | $2,089.30 | $5,248.07 | $11,748.98 |
United Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $457.09 | Professional | None | $223.87 | $302.00 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
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 $177.83 Median $186.21 Typical High $194.98 | Professional | 52 · Reduced service | $177.83 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $74.13 Typical High $77.62 | Professional | 53 · Discontinued | $72.44 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $281.84 Typical High $295.12 | Professional | 54 · Surgery only | $269.15 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $56.23 Typical High $58.88 | Professional | 55 · Aftercare only | $53.70 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $37.15 Typical High $38.90 | Professional | 56 · Pre-op care only | $36.31 | $37.15 | $38.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $186.21 Typical High $194.98 | Professional | 52 · Reduced service | $177.83 | $186.21 | $194.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $74.13 Typical High $77.62 | Professional | 53 · Discontinued | $72.44 | $74.13 | $77.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $281.84 Typical High $295.12 | Professional | 54 · Surgery only | $269.15 | $281.84 | $295.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $56.23 Typical High $58.88 | Professional | 55 · Aftercare only | $53.70 | $56.23 | $58.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $37.15 Typical High $38.90 | Professional | 56 · Pre-op care only | $36.31 | $37.15 | $38.90 |
Where Texas sits
The same service costs 7.8 times more in Texas than in Delaware. 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
$2,399
TX $2,399DE $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.