How much rates vary
Facilitymedian $372 · 10th to 90th $288 to $676Professionalmedian $372 · 10th to 90th $295 to $5,129
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 $295.12 Median $295.12 Typical High $316.23 | Facility | None | $295.12 | $295.12 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $588.84 | Professional | None | $295.12 | $295.12 | $588.84 |
Christus Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
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 $3,388.44 Median $5,128.61 Typical High $5,128.61 | Professional | None | $3,388.44 | $5,128.61 | $5,128.61 |
Moda Health Setting Facility Modifier None Typical Low $194.98 Median $380.19 Typical High $676.08 | Facility | None | $194.98 | $380.19 | $676.08 |
Moda Health Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $588.84 | Professional | None | $295.12 | $295.12 | $588.84 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $371.54 Typical High $676.08 | Facility | None | $288.40 | $371.54 | $676.08 |
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 $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $457.09 | Professional | None | $251.19 | $380.19 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
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 $147.91 Median $147.91 Typical High $295.12 | Professional | 52 · Reduced service | $147.91 | $147.91 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $117.49 | Professional | 53 · Discontinued | $58.88 | $58.88 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $87.10 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $58.88 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $58.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $147.91 Typical High $295.12 | Professional | 52 · Reduced service | $147.91 | $147.91 | $295.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $117.49 | Professional | 53 · Discontinued | $58.88 | $58.88 | $117.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $87.10 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $87.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $58.88 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $58.88 |
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· 31st of 51
$372
MT $708NY $275
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.