How much rates vary
Facilitymedian $2,399 · 10th to 90th $437 to $8,511Professionalmedian $437 · 10th to 90th $63 to $4,074
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 $1,230.27 Median $4,265.80 Typical High $9,772.37 | Facility | None | $1,230.27 | $4,265.80 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $4,897.79 | Professional | None | $371.54 | $426.58 | $4,897.79 |
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 $371.54 Median $489.78 Typical High $1,023.29 | Professional | None | $371.54 | $489.78 | $1,023.29 |
Lucent Health Setting Professional Modifier None Typical Low $3,467.37 Median $4,073.80 Typical High $4,073.80 | Professional | None | $3,467.37 | $4,073.80 | $4,073.80 |
Moda Health Setting Facility Modifier None Typical Low $446.68 Median $2,511.89 Typical High $7,943.28 | Facility | None | $446.68 | $2,511.89 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $691.83 | Professional | None | $371.54 | $426.58 | $691.83 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $295.12 Typical High $407.38 | Professional | None | $53.70 | $295.12 | $407.38 |
Providence Setting Facility Modifier None Typical Low $371.54 Median $758.58 Typical High $2,691.53 | Facility | None | $371.54 | $758.58 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $1,023.29 | Professional | None | $371.54 | $489.78 | $1,023.29 |
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 $338.84 Median $602.56 Typical High $933.25 | Professional | None | $338.84 | $602.56 | $933.25 |
Wellpoint Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
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 $186.21 Median $208.93 Typical High $234.42 | Professional | 52 · Reduced service | $186.21 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $83.18 Typical High $95.50 | Professional | 53 · Discontinued | $74.13 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $316.23 Typical High $354.81 | Professional | 54 · Surgery only | $281.84 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $63.10 Typical High $70.79 | Professional | 55 · Aftercare only | $56.23 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $41.69 Typical High $47.86 | Professional | 56 · Pre-op care only | $37.15 | $41.69 | $47.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $208.93 Typical High $234.42 | Professional | 52 · Reduced service | $186.21 | $208.93 | $234.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $83.18 Typical High $95.50 | Professional | 53 · Discontinued | $74.13 | $83.18 | $95.50 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $316.23 Typical High $354.81 | Professional | 54 · Surgery only | $281.84 | $316.23 | $354.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $63.10 Typical High $70.79 | Professional | 55 · Aftercare only | $56.23 | $63.10 | $70.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $41.69 Typical High $47.86 | Professional | 56 · Pre-op care only | $37.15 | $41.69 | $47.86 |
Where Texas sits
The same service costs 3.7 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· 48th of 51
$525
WI $1,622NY $437
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.