How much rates vary
Facilitymedian $14,791 · 10th to 90th $1,148 to $38,905Professionalmedian $3,715 · 10th to 90th $468 to $5,623
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 $1,000.00 Median $3,630.78 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $4,168.69 | Professional | None | $467.74 | $489.78 | $4,168.69 |
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 $3,715.35 Median $5,623.41 Typical High $5,623.41 | Professional | None | $3,715.35 | $5,623.41 | $5,623.41 |
Moda Health Setting Facility Modifier None Typical Low $489.78 Median $3,019.95 Typical High $6,918.31 | Facility | None | $489.78 | $3,019.95 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $524.81 | Professional | None | $467.74 | $489.78 | $524.81 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $21,379.62 Typical High $30,902.95 | Facility | None | $537.03 | $21,379.62 | $30,902.95 |
Providence Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
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 $389.05 Median $575.44 Typical High $870.96 | Professional | None | $389.05 | $575.44 | $870.96 |
Wellpoint Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
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 $234.42 Median $245.47 Typical High $251.19 | Professional | 52 · Reduced service | $234.42 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $97.72 Typical High $102.33 | Professional | 53 · Discontinued | $93.33 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $363.08 Typical High $380.19 | Professional | 54 · Surgery only | $354.81 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $72.44 Typical High $75.86 | Professional | 55 · Aftercare only | $70.79 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $48.98 Typical High $51.29 | Professional | 56 · Pre-op care only | $46.77 | $48.98 | $51.29 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $245.47 Typical High $251.19 | Professional | 52 · Reduced service | $234.42 | $245.47 | $251.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $97.72 Typical High $102.33 | Professional | 53 · Discontinued | $93.33 | $97.72 | $102.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $363.08 Typical High $380.19 | Professional | 54 · Surgery only | $354.81 | $363.08 | $380.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $72.44 Typical High $75.86 | Professional | 55 · Aftercare only | $70.79 | $72.44 | $75.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $48.98 Typical High $51.29 | Professional | 56 · Pre-op care only | $46.77 | $48.98 | $51.29 |
Where Texas sits
The same service costs 29.5 times more in Louisiana than in Maine. 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· 11th of 51
$3,890
LA $16,982ME $575
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.