How much rates vary
Facilitymedian $4,677 · 10th to 90th $3,020 to $7,079Professionalmedian $3,631 · 10th to 90th $3,020 to $53,703
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 $3,090.30 Median $3,090.30 Typical High $3,311.31 | Facility | None | $3,090.30 | $3,090.30 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $6,165.95 | Professional | None | $3,090.30 | $3,090.30 | $6,165.95 |
Christus Setting Facility Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Facility | None | $7,079.46 | $7,079.46 | $7,079.46 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,677.35 | Professional | None | $3,467.37 | $3,467.37 | $4,677.35 |
Lucent Health Setting Professional Modifier None Typical Low $53,703.18 Median $53,703.18 Typical High $53,703.18 | Professional | None | $53,703.18 | $53,703.18 | $53,703.18 |
Moda Health Setting Facility Modifier None Typical Low $1,949.84 Median $3,981.07 Typical High $7,079.46 | Facility | None | $1,949.84 | $3,981.07 | $7,079.46 |
Moda Health Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $6,165.95 | Professional | None | $3,090.30 | $3,090.30 | $6,165.95 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $3,890.45 Typical High $3,890.45 | Professional | None | $81.28 | $3,890.45 | $3,890.45 |
Providence Setting Facility Modifier None Typical Low $3,019.95 Median $4,677.35 Typical High $7,079.46 | Facility | None | $3,019.95 | $4,677.35 | $7,079.46 |
Providence Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,677.35 | Professional | None | $3,467.37 | $3,467.37 | $4,677.35 |
United Setting Facility Modifier None Typical Low $4,073.80 Median $4,897.79 Typical High $7,079.46 | Facility | None | $4,073.80 | $4,897.79 | $7,079.46 |
United Setting Professional Modifier None Typical Low $2,511.89 Median $3,801.89 Typical High $4,570.88 | Professional | None | $2,511.89 | $3,801.89 | $4,570.88 |
Wellpoint Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,715.35 | Professional | None | $3,630.78 | $3,630.78 | $3,715.35 |
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 $1,548.82 Median $1,548.82 Typical High $3,090.30 | Professional | 52 · Reduced service | $1,548.82 | $1,548.82 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $616.60 Typical High $1,230.27 | Professional | 53 · Discontinued | $616.60 | $616.60 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $457.09 Typical High $912.01 | Professional | 55 · Aftercare only | $457.09 | $457.09 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $309.03 Typical High $616.60 | Professional | 56 · Pre-op care only | $309.03 | $309.03 | $616.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,548.82 Median $1,548.82 Typical High $3,090.30 | Professional | 52 · Reduced service | $1,548.82 | $1,548.82 | $3,090.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $616.60 Typical High $1,230.27 | Professional | 53 · Discontinued | $616.60 | $616.60 | $1,230.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $457.09 Typical High $912.01 | Professional | 55 · Aftercare only | $457.09 | $457.09 | $912.01 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $309.03 Typical High $616.60 | Professional | 56 · Pre-op care only | $309.03 | $309.03 | $616.60 |
Where Texas sits
The same service costs 3.9 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· 32nd of 51
$3,715
HI $12,882DC $3,311
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.