How much rates vary
Facilitymedian $417 · 10th to 90th $224 to $537Professionalmedian $355 · 10th to 90th $229 to $3,981
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 $229.09 Median $229.09 Typical High $338.84 | Facility | None | $229.09 | $229.09 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $457.09 | Professional | None | $229.09 | $229.09 | $457.09 |
Christus Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $416.87 | Professional | None | $354.81 | $354.81 | $416.87 |
Lucent Health Setting Professional Modifier None Typical Low $2,691.53 Median $3,981.07 Typical High $3,981.07 | Professional | None | $2,691.53 | $3,981.07 | $3,981.07 |
Moda Health Setting Facility Modifier None Typical Low $151.36 Median $295.12 Typical High $537.03 | Facility | None | $151.36 | $295.12 | $537.03 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $457.09 | Professional | None | $229.09 | $229.09 | $457.09 |
Molina Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $398.11 | Professional | None | $363.08 | $398.11 | $398.11 |
Providence Setting Facility Modifier None Typical Low $223.87 Median $416.87 Typical High $537.03 | Facility | None | $223.87 | $416.87 | $537.03 |
Providence Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $416.87 | Professional | None | $354.81 | $354.81 | $416.87 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
United Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $354.81 | Professional | None | $194.98 | $295.12 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $288.40 | Professional | None | $281.84 | $281.84 | $288.40 |
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 $114.82 Median $114.82 Typical High $229.09 | Professional | 52 · Reduced service | $114.82 | $114.82 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $91.20 | Professional | 53 · Discontinued | $45.71 | $45.71 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $69.18 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $45.71 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $45.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $114.82 Typical High $229.09 | Professional | 52 · Reduced service | $114.82 | $114.82 | $229.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $91.20 | Professional | 53 · Discontinued | $45.71 | $45.71 | $91.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $69.18 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $69.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $45.71 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $45.71 |
Where Texas sits
The same service costs 2.5 times more in Montana than in New York. 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
$355
MT $550NY $219
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.