How much rates vary
Facilitymedian $12,589 · 10th to 90th $7,943 to $23,442Professionalmedian $11,749 · 10th to 90th $9,120 to $134,896
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 $10,000.00 Median $10,000.00 Typical High $10,964.78 | Facility | None | $10,000.00 | $10,000.00 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $20,417.38 | Professional | None | $10,000.00 | $10,000.00 | $20,417.38 |
Christus Setting Facility Modifier None Typical Low $23,442.29 Median $23,442.29 Typical High $23,442.29 | Facility | None | $23,442.29 | $23,442.29 | $23,442.29 |
Cigna Setting Facility Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $12,589.25 | Facility | None | $12,589.25 | $12,589.25 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $12,589.25 | Professional | None | $9,120.11 | $9,120.11 | $12,589.25 |
Lucent Health Setting Professional Modifier None Typical Low $117,489.76 Median $134,896.29 Typical High $134,896.29 | Professional | None | $117,489.76 | $134,896.29 | $134,896.29 |
Moda Health Setting Facility Modifier None Typical Low $5,623.41 Median $12,882.50 Typical High $23,442.29 | Facility | None | $5,623.41 | $12,882.50 | $23,442.29 |
Moda Health Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $20,417.38 | Professional | None | $10,000.00 | $10,000.00 | $20,417.38 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $17,378.01 Typical High $17,378.01 | Professional | None | $81.28 | $17,378.01 | $17,378.01 |
Providence Setting Facility Modifier None Typical Low $10,000.00 Median $12,589.25 Typical High $23,442.29 | Facility | None | $10,000.00 | $12,589.25 | $23,442.29 |
Providence Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $12,589.25 | Professional | None | $9,120.11 | $9,120.11 | $12,589.25 |
United Setting Facility Modifier None Typical Low $7,943.28 Median $9,332.54 Typical High $20,417.38 | Facility | None | $7,943.28 | $9,332.54 | $20,417.38 |
United Setting Professional Modifier None Typical Low $7,244.36 Median $10,964.78 Typical High $13,182.57 | Professional | None | $7,244.36 | $10,964.78 | $13,182.57 |
Wellpoint Setting Professional Modifier None Typical Low $10,715.19 Median $10,715.19 Typical High $10,715.19 | Professional | None | $10,715.19 | $10,715.19 | $10,715.19 |
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 $5,011.87 Median $5,011.87 Typical High $10,000.00 | Professional | 52 · Reduced service | $5,011.87 | $5,011.87 | $10,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2,041.74 Median $2,041.74 Typical High $4,073.80 | Professional | 53 · Discontinued | $2,041.74 | $2,041.74 | $4,073.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,513.56 Median $1,513.56 Typical High $3,019.95 | Professional | 55 · Aftercare only | $1,513.56 | $1,513.56 | $3,019.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,000.00 Median $1,000.00 Typical High $2,041.74 | Professional | 56 · Pre-op care only | $1,000.00 | $1,000.00 | $2,041.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $5,011.87 Median $5,011.87 Typical High $10,000.00 | Professional | 52 · Reduced service | $5,011.87 | $5,011.87 | $10,000.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2,041.74 Median $2,041.74 Typical High $4,073.80 | Professional | 53 · Discontinued | $2,041.74 | $2,041.74 | $4,073.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1,513.56 Median $1,513.56 Typical High $3,019.95 | Professional | 55 · Aftercare only | $1,513.56 | $1,513.56 | $3,019.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1,000.00 Median $1,000.00 Typical High $2,041.74 | Professional | 56 · Pre-op care only | $1,000.00 | $1,000.00 | $2,041.74 |
Where Texas sits
The same service costs 2.5 times more in Montana than in Florida. 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· 23rd of 51
$12,589
MT $22,387FL $9,120
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.