How much rates vary
Facilitymedian $245 · 10th to 90th $170 to $437Professionalmedian $229 · 10th to 90th $178 to $3,467
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 $190.55 Median $190.55 Typical High $204.17 | Facility | None | $190.55 | $190.55 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $380.19 | Professional | None | $190.55 | $190.55 | $380.19 |
Christus Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
Lucent Health Setting Professional Modifier None Typical Low $2,187.76 Median $3,467.37 Typical High $3,467.37 | Professional | None | $2,187.76 | $3,467.37 | $3,467.37 |
Moda Health Setting Facility Modifier None Typical Low $107.15 Median $245.47 Typical High $436.52 | Facility | None | $107.15 | $245.47 | $436.52 |
Moda Health Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $380.19 | Professional | None | $190.55 | $190.55 | $380.19 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $257.04 Typical High $257.04 | Professional | None | $81.28 | $257.04 | $257.04 |
Providence Setting Facility Modifier None Typical Low $186.21 Median $245.47 Typical High $436.52 | Facility | None | $186.21 | $245.47 | $436.52 |
Providence Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $245.47 | Professional | None | $177.83 | $177.83 | $245.47 |
United Setting Facility Modifier None Typical Low $169.82 Median $173.78 Typical High $389.05 | Facility | None | $169.82 | $173.78 | $389.05 |
United Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $251.19 | Professional | None | $141.25 | $208.93 | $251.19 |
Wellpoint Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
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 $95.50 Median $95.50 Typical High $190.55 | Professional | 52 · Reduced service | $95.50 | $95.50 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $75.86 | Professional | 53 · Discontinued | $38.02 | $38.02 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $56.23 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $38.02 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $38.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $95.50 Typical High $190.55 | Professional | 52 · Reduced service | $95.50 | $95.50 | $190.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $75.86 | Professional | 53 · Discontinued | $38.02 | $38.02 | $75.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $56.23 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $56.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $38.02 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $38.02 |
Where Texas sits
The same service costs 2.3 times more in Wisconsin than in Colorado. 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
$240
WI $407CO $178
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.