How much rates vary
Facilitymedian $2,138 · 10th to 90th $479 to $7,244Professionalmedian $776 · 10th to 90th $115 to $5,888
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 $870.96 Median $3,890.45 Typical High $10,715.19 | Facility | None | $870.96 | $3,890.45 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,000.00 | Professional | None | $707.95 | $794.33 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,479.11 Typical High $2,691.53 | Facility | None | $537.03 | $1,479.11 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,288.25 | Professional | None | $676.08 | $912.01 | $1,288.25 |
Lucent Health Setting Professional Modifier None Typical Low $5,128.61 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,128.61 | $5,888.44 | $5,888.44 |
Moda Health Setting Facility Modifier None Typical Low $691.83 Median $2,187.76 Typical High $6,918.31 | Facility | None | $691.83 | $2,187.76 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,023.29 | Professional | None | $707.95 | $812.83 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $537.03 Typical High $741.31 | Professional | None | $97.72 | $537.03 | $741.31 |
Providence Setting Facility Modifier None Typical Low $588.84 Median $977.24 Typical High $2,691.53 | Facility | None | $588.84 | $977.24 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,288.25 | Professional | None | $676.08 | $912.01 | $1,288.25 |
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 $588.84 Median $851.14 Typical High $1,318.26 | Professional | None | $588.84 | $851.14 | $1,318.26 |
Wellpoint Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
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 $354.81 Median $398.11 Typical High $446.68 | Professional | 52 · Reduced service | $354.81 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $158.49 Typical High $181.97 | Professional | 53 · Discontinued | $141.25 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $602.56 Typical High $676.08 | Professional | 54 · Surgery only | $537.03 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $120.23 Typical High $134.90 | Professional | 55 · Aftercare only | $107.15 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $79.43 Typical High $91.20 | Professional | 56 · Pre-op care only | $70.79 | $79.43 | $91.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $354.81 Median $398.11 Typical High $446.68 | Professional | 52 · Reduced service | $354.81 | $398.11 | $446.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $158.49 Typical High $181.97 | Professional | 53 · Discontinued | $141.25 | $158.49 | $181.97 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $602.56 Typical High $676.08 | Professional | 54 · Surgery only | $537.03 | $602.56 | $676.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $120.23 Typical High $134.90 | Professional | 55 · Aftercare only | $107.15 | $120.23 | $134.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $79.43 Typical High $91.20 | Professional | 56 · Pre-op care only | $70.79 | $79.43 | $91.20 |
Where Texas sits
The same service costs 3.8 times more in Wisconsin 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· 50th of 51
$813
WI $2,951NY $776
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.