How much rates vary
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 $1,148.15 Median $1,148.15 Typical High $1,258.93 | Facility | None | $1,148.15 | $1,148.15 | $1,258.93 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,148.15 | $2,290.87 |
Christus Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
Lucent Health Setting Professional Modifier None Typical Low $13,489.63 Median $19,952.62 Typical High $19,952.62 | Professional | None | $13,489.63 | $19,952.62 | $19,952.62 |
Moda Health Setting Facility Modifier None Typical Low $758.58 Median $1,479.11 Typical High $2,691.53 | Facility | None | $758.58 | $1,479.11 | $2,691.53 |
Moda Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,148.15 | $2,290.87 |
Providence Setting Facility Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $2,691.53 | Facility | None | $1,122.02 | $1,479.11 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,479.11 Typical High $1,778.28 | Professional | None | $977.24 | $1,479.11 | $1,778.28 |
Wellpoint Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,445.44 | Professional | None | $1,412.54 | $1,412.54 | $1,445.44 |
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 $575.44 Median $575.44 Typical High $1,148.15 | Professional | 52 · Reduced service | $575.44 | $575.44 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $457.09 | Professional | 53 · Discontinued | $229.09 | $229.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $346.74 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $229.09 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $229.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $575.44 Typical High $1,148.15 | Professional | 52 · Reduced service | $575.44 | $575.44 | $1,148.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $457.09 | Professional | 53 · Discontinued | $229.09 | $229.09 | $457.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $346.74 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $346.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $229.09 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $229.09 |
Where Texas sits
The same service costs 2.6 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· 28th of 51
$1,479
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.