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 $223.87 Median $251.19 Typical High $316.23 | Professional | None | $223.87 | $251.19 | $316.23 |
BCBS Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $371.54 | Professional | None | $208.93 | $263.03 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,258.93 Typical High $2,691.53 | Facility | None | $630.96 | $1,258.93 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $398.11 | Professional | None | $213.80 | $288.40 | $398.11 |
Lucent Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,621.81 | $1,905.46 | $1,905.46 |
Moda Health Setting Facility Modifier None Typical Low $223.87 Median $1,995.26 Typical High $6,918.31 | Facility | None | $223.87 | $1,995.26 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $323.59 | Professional | None | $223.87 | $257.04 | $323.59 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $162.18 Typical High $223.87 | Professional | None | $29.51 | $162.18 | $223.87 |
Providence Setting Facility Modifier None Typical Low $371.54 Median $1,479.11 Typical High $251,188.64 | Facility | None | $371.54 | $1,479.11 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $398.11 | Professional | None | $213.80 | $288.40 | $398.11 |
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 $186.21 Median $269.15 Typical High $407.38 | Professional | None | $186.21 | $269.15 | $407.38 |
Wellpoint Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
4 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 $112.20 Median $125.89 Typical High $141.25 | Professional | 52 · Reduced service | $112.20 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $50.12 Typical High $57.54 | Professional | 53 · Discontinued | $44.67 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $38.02 Typical High $42.66 | Professional | 55 · Aftercare only | $33.88 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $25.12 Typical High $28.18 | Professional | 56 · Pre-op care only | $22.39 | $25.12 | $28.18 |
Where Texas sits
The same service costs 4.1 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· 46th of 51
$288
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.