How much rates vary
Facilitymedian $389 · 10th to 90th $224 to $537Professionalmedian $302 · 10th to 90th $229 to $3,802
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 $234.42 Median $234.42 Typical High $245.47 | Facility | None | $234.42 | $234.42 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $302.00 | Professional | None | $229.09 | $245.47 | $302.00 |
Christus Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | None | $281.84 | $281.84 | $389.05 |
Lucent Health Setting Professional Modifier None Typical Low $3,630.78 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,630.78 | $3,801.89 | $3,801.89 |
Moda Health Setting Facility Modifier None Typical Low $158.49 Median $295.12 Typical High $537.03 | Facility | None | $158.49 | $295.12 | $537.03 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $407.38 | Professional | None | $229.09 | $245.47 | $407.38 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $281.84 Typical High $281.84 | Professional | None | $81.28 | $281.84 | $281.84 |
Providence Setting Facility Modifier None Typical Low $223.87 Median $389.05 Typical High $537.03 | Facility | None | $223.87 | $389.05 | $537.03 |
Providence Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | None | $281.84 | $281.84 | $389.05 |
United Setting Facility Modifier None Typical Low $331.13 Median $426.58 Typical High $575.44 | Facility | None | $331.13 | $426.58 | $575.44 |
United Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $354.81 | Professional | None | $190.55 | $275.42 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
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 $114.82 Median $123.03 Typical High $151.36 | Professional | 52 · Reduced service | $114.82 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $48.98 Typical High $60.26 | Professional | 53 · Discontinued | $45.71 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $36.31 Typical High $45.71 | Professional | 55 · Aftercare only | $34.67 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $22.91 | $24.55 | $30.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $123.03 Typical High $151.36 | Professional | 52 · Reduced service | $114.82 | $123.03 | $151.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $48.98 Typical High $60.26 | Professional | 53 · Discontinued | $45.71 | $48.98 | $60.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $36.31 Typical High $44.67 | Professional | 55 · Aftercare only | $34.67 | $36.31 | $44.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $22.91 | $24.55 | $30.20 |
Where Texas sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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· 36th of 51
$302
HI $891DC $263
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.