How much rates vary
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 Typical Low $77.62 Median $81.28 Typical High $1,096.48 | Professional | None | $77.62 | $81.28 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,511.89 Typical High $19,054.61 | Facility | None | $758.58 | $2,511.89 | $19,054.61 |
Lucent Health Setting Professional Modifier None Typical Low $18,620.87 Median $18,620.87 Typical High $18,620.87 | Professional | None | $18,620.87 | $18,620.87 | $18,620.87 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $2,454.71 Typical High $6,918.31 | Facility | None | $117.49 | $2,454.71 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $83.18 | Professional | None | $77.62 | $81.28 | $83.18 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $251,188.64 | Facility | None | $537.03 | $2,511.89 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
United Setting Facility Modifier None Typical Low $407.38 Median $2,137.96 Typical High $8,912.51 | Facility | None | $407.38 | $2,137.96 | $8,912.51 |
United Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $147.91 | Professional | None | $64.57 | $93.33 | $147.91 |
Wellpoint Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
8 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 $38.90 Median $40.74 Typical High $41.69 | Professional | 52 · Reduced service | $38.90 | $40.74 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $16.22 Typical High $16.60 | Professional | 53 · Discontinued | $15.49 | $16.22 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.30 Typical High $12.59 | Professional | 55 · Aftercare only | $11.75 | $12.30 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.13 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.76 | $8.13 | $8.32 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $40.74 Typical High $41.69 | Professional | 52 · Reduced service | $38.90 | $40.74 | $41.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $16.22 Typical High $16.60 | Professional | 53 · Discontinued | $15.49 | $16.22 | $16.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.30 Typical High $12.59 | Professional | 55 · Aftercare only | $11.75 | $12.30 | $12.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.13 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.76 | $8.13 | $8.32 |
Where Texas sits
The same service costs 30.9 times more in California than in Idaho. 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· 6th of 51
$1,778
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.