How much rates vary
Facilitymedian $1,585 · 10th to 90th $603 to $4,786Professionalmedian $204 · 10th to 90th $32 to $1,660
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 $660.69 Median $2,398.83 Typical High $6,918.31 | Facility | None | $660.69 | $2,398.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $234.42 Typical High $331.13 | Professional | None | $218.78 | $234.42 | $331.13 |
Christus Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $870.96 Typical High $2,818.38 | Facility | None | $630.96 | $870.96 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $309.03 | Professional | None | $181.97 | $263.03 | $309.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,659.59 | $1,698.24 | $1,698.24 |
Moda Health Setting Facility Modifier None Typical Low $239.88 Median $1,905.46 Typical High $5,623.41 | Facility | None | $239.88 | $1,905.46 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $218.78 Median $234.42 Typical High $281.84 | Professional | None | $218.78 | $234.42 | $281.84 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $162.18 Typical High $218.78 | Professional | None | $29.51 | $162.18 | $218.78 |
Oscar Health Setting Professional Modifier None Typical Low $213.80 Median $398.11 Typical High $741.31 | Professional | None | $213.80 | $398.11 | $741.31 |
Providence Setting Facility Modifier None Typical Low $562.34 Median $954.99 Typical High $7,244.36 | Facility | None | $562.34 | $954.99 | $7,244.36 |
Providence Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $309.03 | Professional | None | $181.97 | $263.03 | $309.03 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $363.08 | Professional | None | $181.97 | $245.47 | $363.08 |
Wellpoint Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
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 $109.65 Median $114.82 Typical High $138.04 | Professional | 52 · Reduced service | $109.65 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $46.77 Typical High $54.95 | Professional | 53 · Discontinued | $43.65 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $173.78 Typical High $208.93 | Professional | 54 · Surgery only | $165.96 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $34.67 Typical High $41.69 | Professional | 55 · Aftercare only | $33.11 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $23.44 Typical High $27.54 | Professional | 56 · Pre-op care only | $21.88 | $23.44 | $27.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $114.82 Typical High $128.82 | Professional | 52 · Reduced service | $109.65 | $114.82 | $128.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $46.77 Typical High $52.48 | Professional | 53 · Discontinued | $43.65 | $46.77 | $52.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $173.78 Typical High $194.98 | Professional | 54 · Surgery only | $165.96 | $173.78 | $194.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $34.67 Typical High $38.90 | Professional | 55 · Aftercare only | $33.11 | $34.67 | $38.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $23.44 Typical High $25.70 | Professional | 56 · Pre-op care only | $21.88 | $23.44 | $25.70 |
Where Texas sits
The same service costs 4.7 times more in Wyoming than in Utah. 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
$209
WY $912UT $195
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.