How much rates vary
Facilitymedian $9,772 · 10th to 90th $1,148 to $38,019Professionalmedian $3,388 · 10th to 90th $437 to $3,802
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 $501.19 Median $524.81 Typical High $4,168.69 | Professional | None | $501.19 | $524.81 | $4,168.69 |
Christus Setting Facility Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $9,549.93 | Facility | None | $9,549.93 | $9,549.93 | $9,549.93 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $9,120.11 Typical High $12,882.50 | Facility | None | $758.58 | $9,120.11 | $12,882.50 |
Lucent Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,388.44 | $3,801.89 | $3,801.89 |
Moda Health Setting Facility Modifier None Typical Low $524.81 Median $3,019.95 Typical High $6,918.31 | Facility | None | $524.81 | $3,019.95 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $562.34 | Professional | None | $501.19 | $524.81 | $562.34 |
Providence Setting Facility Modifier None Typical Low $549.54 Median $8,912.51 Typical High $12,882.50 | Facility | None | $549.54 | $8,912.51 | $12,882.50 |
Providence Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
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 $398.11 Median $575.44 Typical High $891.25 | Professional | None | $398.11 | $575.44 | $891.25 |
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 $251.19 Median $263.03 Typical High $275.42 | Professional | 52 · Reduced service | $251.19 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $104.71 Typical High $109.65 | Professional | 53 · Discontinued | $102.33 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $398.11 Typical High $407.38 | Professional | 54 · Surgery only | $380.19 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $79.43 Typical High $83.18 | Professional | 55 · Aftercare only | $75.86 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $52.48 Typical High $54.95 | Professional | 56 · Pre-op care only | $51.29 | $52.48 | $54.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $263.03 Typical High $275.42 | Professional | 52 · Reduced service | $251.19 | $263.03 | $275.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $104.71 Typical High $109.65 | Professional | 53 · Discontinued | $102.33 | $104.71 | $109.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $398.11 Typical High $407.38 | Professional | 54 · Surgery only | $380.19 | $398.11 | $407.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $79.43 Typical High $83.18 | Professional | 55 · Aftercare only | $75.86 | $79.43 | $83.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $52.48 Typical High $54.95 | Professional | 56 · Pre-op care only | $51.29 | $52.48 | $54.95 |
Where Texas sits
The same service costs 24.0 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· 10th of 51
$3,802
AR $10,000NY $417
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.