How much rates vary
Facilitymedian $363 · 10th to 90th $288 to $692Professionalmedian $363 · 10th to 90th $263 to $4,571
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 $302.00 Median $302.00 Typical High $323.59 | Facility | None | $302.00 | $302.00 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $602.56 | Professional | None | $302.00 | $302.00 | $602.56 |
Christus Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | None | $263.03 | $263.03 | $363.08 |
Lucent Health Setting Professional Modifier None Typical Low $3,981.07 Median $4,570.88 Typical High $4,570.88 | Professional | None | $3,981.07 | $4,570.88 | $4,570.88 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $380.19 Typical High $691.83 | Facility | None | $165.96 | $380.19 | $691.83 |
Moda Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $602.56 | Professional | None | $302.00 | $302.00 | $602.56 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $380.19 Typical High $380.19 | Professional | None | $81.28 | $380.19 | $380.19 |
Providence Setting Facility Modifier None Typical Low $295.12 Median $363.08 Typical High $691.83 | Facility | None | $295.12 | $363.08 | $691.83 |
Providence Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | None | $263.03 | $263.03 | $363.08 |
United Setting Facility Modifier None Typical Low $346.74 Median $416.87 Typical High $602.56 | Facility | None | $346.74 | $416.87 | $602.56 |
United Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $389.05 | Professional | None | $213.80 | $323.59 | $389.05 |
Wellpoint Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
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 $147.91 Median $147.91 Typical High $302.00 | Professional | 52 · Reduced service | $147.91 | $147.91 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $120.23 | Professional | 53 · Discontinued | $60.26 | $60.26 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $89.13 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $60.26 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $60.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $147.91 Typical High $302.00 | Professional | 52 · Reduced service | $147.91 | $147.91 | $302.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $120.23 | Professional | 53 · Discontinued | $60.26 | $60.26 | $120.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $89.13 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $89.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $60.26 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $60.26 |
Where Texas sits
The same service costs 3.7 times more in Hawaii than in Delaware. 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· 24th of 51
$363
HI $977DE $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.