How much rates vary
Facilitymedian $1,148 · 10th to 90th $794 to $1,862Professionalmedian $851 · 10th to 90th $676 to $13,490
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 $831.76 Median $831.76 Typical High $851.14 | Facility | None | $831.76 | $831.76 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $1,023.29 | Professional | None | $812.83 | $851.14 | $1,023.29 |
Christus Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,148.15 | Professional | None | $831.76 | $831.76 | $1,148.15 |
Lucent Health Setting Professional Modifier None Typical Low $13,489.63 Median $13,489.63 Typical High $13,489.63 | Professional | None | $13,489.63 | $13,489.63 | $13,489.63 |
Moda Health Setting Facility Modifier None Typical Low $478.63 Median $1,047.13 Typical High $1,862.09 | Facility | None | $478.63 | $1,047.13 | $1,862.09 |
Moda Health Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $1,122.02 | Professional | None | $812.83 | $851.14 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $1,096.48 Typical High $1,096.48 | Professional | None | $81.28 | $1,096.48 | $1,096.48 |
Providence Setting Facility Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,862.09 | Facility | None | $794.33 | $1,148.15 | $1,862.09 |
Providence Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,148.15 | Professional | None | $831.76 | $831.76 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,698.24 | Facility | None | $1,000.00 | $1,258.93 | $1,698.24 |
United Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,071.52 | Professional | None | $575.44 | $812.83 | $1,071.52 |
Wellpoint Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
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 $407.38 Median $426.58 Typical High $512.86 | Professional | 52 · Reduced service | $407.38 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $169.82 Typical High $204.17 | Professional | 53 · Discontinued | $162.18 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $128.82 Typical High $154.88 | Professional | 55 · Aftercare only | $120.23 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $85.11 Typical High $102.33 | Professional | 56 · Pre-op care only | $81.28 | $85.11 | $102.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $426.58 Typical High $489.78 | Professional | 52 · Reduced service | $407.38 | $426.58 | $489.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $169.82 Typical High $194.98 | Professional | 53 · Discontinued | $162.18 | $169.82 | $194.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $128.82 Typical High $147.91 | Professional | 55 · Aftercare only | $120.23 | $128.82 | $147.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $85.11 Typical High $97.72 | Professional | 56 · Pre-op care only | $81.28 | $85.11 | $97.72 |
Where Texas sits
The same service costs 3.9 times more in Hawaii than in West Virginia. 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· 30th of 51
$912
HI $3,236WV $832
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.