How much rates vary
Facilitymedian $372 · 10th to 90th $182 to $427Professionalmedian $316 · 10th to 90th $182 to $3,236
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 $181.97 Median $181.97 Typical High $199.53 | Facility | None | $181.97 | $181.97 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $371.54 | Professional | None | $181.97 | $181.97 | $371.54 |
BCBS Texas Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Christus Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | None | $316.23 | $316.23 | $371.54 |
Lucent Health Setting Professional Modifier None Typical Low $2,818.38 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,818.38 | $3,235.94 | $3,235.94 |
Moda Health Setting Facility Modifier None Typical Low $134.90 Median $263.03 Typical High $575.44 | Facility | None | $134.90 | $263.03 | $575.44 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $371.54 | Professional | None | $181.97 | $181.97 | $371.54 |
Providence Setting Facility Modifier None Typical Low $181.97 Median $371.54 Typical High $426.58 | Facility | None | $181.97 | $371.54 | $426.58 |
Providence Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | None | $316.23 | $316.23 | $371.54 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $316.23 | Professional | None | $173.78 | $263.03 | $316.23 |
Wellpoint Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $257.04 | Professional | None | $251.19 | $251.19 | $257.04 |
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 $91.20 Median $91.20 Typical High $181.97 | Professional | 52 · Reduced service | $91.20 | $91.20 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $74.13 | Professional | 53 · Discontinued | $37.15 | $37.15 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $54.95 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $37.15 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $37.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $91.20 Typical High $181.97 | Professional | 52 · Reduced service | $91.20 | $91.20 | $181.97 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $74.13 | Professional | 53 · Discontinued | $37.15 | $37.15 | $74.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $54.95 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $54.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $37.15 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $37.15 |
Where Texas sits
The same service costs 3.4 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· 22nd of 51
$316
MT $589NY $174
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.