How much rates vary
Facilitymedian $398 · 10th to 90th $257 to $617Professionalmedian $347 · 10th to 90th $263 to $4,074
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 $263.03 Median $263.03 Typical High $281.84 | Facility | None | $263.03 | $263.03 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $524.81 | Professional | None | $263.03 | $263.03 | $524.81 |
Christus Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Lucent Health Setting Professional Modifier None Typical Low $3,235.94 Median $4,073.80 Typical High $4,073.80 | Professional | None | $3,235.94 | $4,073.80 | $4,073.80 |
Moda Health Setting Facility Modifier None Typical Low $169.82 Median $338.84 Typical High $616.60 | Facility | None | $169.82 | $338.84 | $616.60 |
Moda Health Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $524.81 | Professional | None | $263.03 | $263.03 | $524.81 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $346.74 Typical High $346.74 | Professional | None | $81.28 | $346.74 | $346.74 |
Providence Setting Facility Modifier None Typical Low $257.04 Median $398.11 Typical High $616.60 | Facility | None | $257.04 | $398.11 | $616.60 |
Providence Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
United Setting Facility Modifier None Typical Low $257.04 Median $331.13 Typical High $616.60 | Facility | None | $257.04 | $331.13 | $616.60 |
United Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $398.11 | Professional | None | $218.78 | $331.13 | $398.11 |
Wellpoint Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $131.83 Median $131.83 Typical High $263.03 | Professional | 52 · Reduced service | $131.83 | $131.83 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $104.71 | Professional | 53 · Discontinued | $52.48 | $52.48 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $79.43 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $52.48 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $52.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $131.83 Typical High $263.03 | Professional | 52 · Reduced service | $131.83 | $131.83 | $263.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $104.71 | Professional | 53 · Discontinued | $52.48 | $52.48 | $104.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $79.43 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $79.43 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $52.48 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $52.48 |
Where Texas sits
The same service costs 2.5 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· 29th of 51
$347
HI $708DC $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.