How much rates vary
Facilitymedian $3,548 · 10th to 90th $54 to $7,943Professionalmedian $83 · 10th to 90th $49 to $490
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 $724.44 Median $3,715.35 Typical High $9,120.11 | Facility | None | $724.44 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None (both parts) Typical Low $48.98 Median $52.48 Typical High $53.70 | Professional | None (both parts) | $48.98 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $19.50 Median $19.95 Typical High $20.42 | Professional | 26 · Professional part | $19.50 | $19.95 | $20.42 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $30.20 Median $32.36 Typical High $33.11 | Professional | TC · Technical part | $30.20 | $32.36 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $37.15 Typical High $42.66 | Facility | None | $33.11 | $37.15 | $42.66 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $407.38 Median $489.78 Typical High $489.78 | Professional | None (both parts) | $407.38 | $489.78 | $489.78 |
Lucent Health Setting Professional Modifier 26 · Professional part Typical Low $162.18 Median $177.83 Typical High $177.83 | Professional | 26 · Professional part | $162.18 | $177.83 | $177.83 |
Lucent Health Setting Professional Modifier TC · Technical part Typical Low $245.47 Median $309.03 Typical High $309.03 | Professional | TC · Technical part | $245.47 | $309.03 | $309.03 |
Moda Health Setting Facility Modifier None Typical Low $53.70 Median $2,511.89 Typical High $6,918.31 | Facility | None | $53.70 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $48.98 Median $52.48 Typical High $53.70 | Professional | None (both parts) | $48.98 | $52.48 | $53.70 |
Moda Health Setting Professional Modifier 26 · Professional part Typical Low $19.50 Median $19.50 Typical High $20.42 | Professional | 26 · Professional part | $19.50 | $19.50 | $20.42 |
Moda Health Setting Professional Modifier TC · Technical part Typical Low $30.20 Median $32.36 Typical High $33.11 | Professional | TC · Technical part | $30.20 | $32.36 | $33.11 |
Providence Setting Facility Modifier None Typical Low $33.11 Median $53.70 Typical High $74.13 | Facility | None | $33.11 | $53.70 | $74.13 |
Providence Setting Professional Modifier None (both parts) Typical Low $53.70 Median $79.43 Typical High $93.33 | Professional | None (both parts) | $53.70 | $79.43 | $93.33 |
United Setting Facility Modifier None Typical Low $56.23 Median $58.88 Typical High $77.62 | Facility | None | $56.23 | $58.88 | $77.62 |
United Setting Professional Modifier None (both parts) Typical Low $40.74 Median $53.70 Typical High $79.43 | Professional | None (both parts) | $40.74 | $53.70 | $79.43 |
United Setting Professional Modifier 26 · Professional part Typical Low $15.49 Median $20.42 Typical High $30.20 | Professional | 26 · Professional part | $15.49 | $20.42 | $30.20 |
United Setting Professional Modifier TC · Technical part Typical Low $25.12 Median $33.11 Typical High $48.98 | Professional | TC · Technical part | $25.12 | $33.11 | $48.98 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None (both parts) | $54.95 | $54.95 | $54.95 |
Wellpoint Setting Professional Modifier 26 · Professional part Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 26 · Professional part | $24.55 | $24.55 | $24.55 |
Wellpoint Setting Professional Modifier TC · Technical part Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | TC · Technical part | $38.90 | $38.90 | $38.90 |
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 $24.55 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $24.55 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.47 Typical High $10.72 | Professional | 53 · Discontinued | $10.00 | $10.47 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $38.90 Typical High $39.81 | Professional | 54 · Surgery only | $37.15 | $38.90 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.76 Typical High $7.94 | Professional | 55 · Aftercare only | $7.41 | $7.76 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.25 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.90 | $5.25 | $5.37 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $24.55 | $26.30 | $26.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.47 Typical High $10.72 | Professional | 53 · Discontinued | $10.00 | $10.47 | $10.72 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $38.90 Typical High $39.81 | Professional | 54 · Surgery only | $37.15 | $38.90 | $39.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.76 Typical High $7.94 | Professional | 55 · Aftercare only | $7.41 | $7.76 | $7.94 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.25 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.90 | $5.25 | $5.37 |
Where Texas sits
The same service costs 3.3 times more in Nebraska 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· 2nd of 51
$97.72
NE $112NY $33.88
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.