How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,096 to $8,710Professionalmedian $5,370 · 10th to 90th $295 to $6,310
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 $645.65 Median $676.08 Typical High $4,168.69 | Professional | None | $645.65 | $676.08 | $4,168.69 |
Christus Setting Facility Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Facility | None | $6,309.57 | $6,309.57 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,888.44 Typical High $8,511.38 | Facility | None | $758.58 | $5,888.44 | $8,511.38 |
Lucent Health Setting Professional Modifier None Typical Low $5,370.32 Median $6,309.57 Typical High $6,309.57 | Professional | None | $5,370.32 | $6,309.57 | $6,309.57 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $3,019.95 Typical High $6,918.31 | Facility | None | $645.65 | $3,019.95 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $645.65 Median $676.08 Typical High $758.58 | Professional | None | $645.65 | $676.08 | $758.58 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $5,888.44 Typical High $8,511.38 | Facility | None | $630.96 | $5,888.44 | $8,511.38 |
Providence Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $10,232.93 | Facility | None | $1,698.24 | $4,570.88 | $10,232.93 |
United Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $602.56 | Professional | None | $281.84 | $398.11 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
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 $323.59 Median $338.84 Typical High $346.74 | Professional | 52 · Reduced service | $323.59 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $134.90 Typical High $141.25 | Professional | 53 · Discontinued | $128.82 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $501.19 Typical High $524.81 | Professional | 54 · Surgery only | $489.78 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $100.00 Typical High $104.71 | Professional | 55 · Aftercare only | $97.72 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $67.61 Typical High $70.79 | Professional | 56 · Pre-op care only | $64.57 | $67.61 | $70.79 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $338.84 Typical High $346.74 | Professional | 52 · Reduced service | $323.59 | $338.84 | $346.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $134.90 Typical High $141.25 | Professional | 53 · Discontinued | $128.82 | $134.90 | $141.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $501.19 Typical High $524.81 | Professional | 54 · Surgery only | $489.78 | $501.19 | $524.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $100.00 Typical High $104.71 | Professional | 55 · Aftercare only | $97.72 | $100.00 | $104.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $67.61 Typical High $70.79 | Professional | 56 · Pre-op care only | $64.57 | $67.61 | $70.79 |
Where Texas sits
The same service costs 14.8 times more in Texas 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· 1st of 51
$5,129
TX $5,129ME $347
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.