How much rates vary
Facilitymedian $646 · 10th to 90th $324 to $759Professionalmedian $479 · 10th to 90th $331 to $5,754
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 $331.13 Median $331.13 Typical High $354.81 | Facility | None | $331.13 | $331.13 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $660.69 | Professional | None | $331.13 | $331.13 | $660.69 |
Christus Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $645.65 | Professional | None | $467.74 | $467.74 | $645.65 |
Lucent Health Setting Professional Modifier None Typical Low $4,786.30 Median $5,754.40 Typical High $5,754.40 | Professional | None | $4,786.30 | $5,754.40 | $5,754.40 |
Moda Health Setting Facility Modifier None Typical Low $239.88 Median $426.58 Typical High $758.58 | Facility | None | $239.88 | $426.58 | $758.58 |
Moda Health Setting Professional Modifier None Typical Low $331.13 Median $346.74 Typical High $660.69 | Professional | None | $331.13 | $346.74 | $660.69 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $398.11 Typical High $398.11 | Professional | None | $81.28 | $398.11 | $398.11 |
Providence Setting Facility Modifier None Typical Low $323.59 Median $645.65 Typical High $758.58 | Facility | None | $323.59 | $645.65 | $758.58 |
Providence Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $645.65 | Professional | None | $467.74 | $467.74 | $645.65 |
United Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $1,023.29 | Facility | None | $489.78 | $489.78 | $1,023.29 |
United Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $562.34 | Professional | None | $309.03 | $467.74 | $562.34 |
Wellpoint Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
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 $165.96 Median $165.96 Typical High $331.13 | Professional | 52 · Reduced service | $165.96 | $165.96 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $131.83 | Professional | 53 · Discontinued | $66.07 | $66.07 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $97.72 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $66.07 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $66.07 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $165.96 Typical High $331.13 | Professional | 52 · Reduced service | $165.96 | $165.96 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $131.83 | Professional | 53 · Discontinued | $66.07 | $66.07 | $131.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $97.72 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $66.07 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $66.07 |
Where Texas sits
The same service costs 2.7 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· 34th of 51
$479
HI $1,096DC $407
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.