How much rates vary
Facilitymedian $427 · 10th to 90th $339 to $813Professionalmedian $417 · 10th to 90th $309 to $6,166
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 $354.81 Median $354.81 Typical High $380.19 | Facility | None | $354.81 | $354.81 | $380.19 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $707.95 | Professional | None | $354.81 | $354.81 | $707.95 |
Christus Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $426.58 | Professional | None | $309.03 | $309.03 | $426.58 |
Lucent Health Setting Professional Modifier None Typical Low $4,073.80 Median $6,165.95 Typical High $6,165.95 | Professional | None | $4,073.80 | $6,165.95 | $6,165.95 |
Moda Health Setting Facility Modifier None Typical Low $194.98 Median $457.09 Typical High $812.83 | Facility | None | $194.98 | $457.09 | $812.83 |
Moda Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $707.95 | Professional | None | $354.81 | $354.81 | $707.95 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $467.74 Typical High $467.74 | Professional | None | $81.28 | $467.74 | $467.74 |
Providence Setting Facility Modifier None Typical Low $346.74 Median $426.58 Typical High $812.83 | Facility | None | $346.74 | $426.58 | $812.83 |
Providence Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $426.58 | Professional | None | $309.03 | $309.03 | $426.58 |
United Setting Facility Modifier None Typical Low $338.84 Median $380.19 Typical High $691.83 | Facility | None | $338.84 | $380.19 | $691.83 |
United Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $457.09 | Professional | None | $251.19 | $380.19 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
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 $177.83 Median $177.83 Typical High $354.81 | Professional | 52 · Reduced service | $177.83 | $177.83 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $141.25 | Professional | 53 · Discontinued | $70.79 | $70.79 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $104.71 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $70.79 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $70.79 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $177.83 Typical High $354.81 | Professional | 52 · Reduced service | $177.83 | $177.83 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $141.25 | Professional | 53 · Discontinued | $70.79 | $70.79 | $141.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $104.71 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $104.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $70.79 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $70.79 |
Where Texas sits
The same service costs 2.7 times more in Hawaii than in Kansas. 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· 25th of 51
$427
HI $759KS $282
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.