How much rates vary
Facilitymedian $5,623 · 10th to 90th $5,623 to $10,233Professionalmedian $5,623 · 10th to 90th $4,467 to $75,858
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 $4,466.84 Median $4,466.84 Typical High $8,912.51 | Facility | None | $4,466.84 | $4,466.84 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $8,912.51 | Professional | None | $4,466.84 | $4,466.84 | $8,912.51 |
BCBS Texas Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
Christus Setting Facility Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $10,232.93 | Facility | None | $10,232.93 | $10,232.93 | $10,232.93 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,623.41 | Professional | None | $4,786.30 | $4,786.30 | $5,623.41 |
Lucent Health Setting Professional Modifier None Typical Low $52,480.75 Median $75,857.76 Typical High $75,857.76 | Professional | None | $52,480.75 | $75,857.76 | $75,857.76 |
Moda Health Setting Facility Modifier None Typical Low $4,466.84 Median $10,232.93 Typical High $10,232.93 | Facility | None | $4,466.84 | $10,232.93 | $10,232.93 |
Moda Health Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $8,912.51 | Professional | None | $4,466.84 | $4,466.84 | $8,912.51 |
Providence Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $10,232.93 | Facility | None | $5,623.41 | $5,623.41 | $10,232.93 |
Providence Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,623.41 | Professional | None | $4,786.30 | $4,786.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $3,801.89 Median $5,754.40 Typical High $7,079.46 | Professional | None | $3,801.89 | $5,754.40 | $7,079.46 |
Wellpoint Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $5,495.41 | Professional | None | $4,897.79 | $4,897.79 | $5,495.41 |
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 $2,238.72 Median $2,238.72 Typical High $4,466.84 | Professional | 52 · Reduced service | $2,238.72 | $2,238.72 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $891.25 Median $891.25 Typical High $1,778.28 | Professional | 53 · Discontinued | $891.25 | $891.25 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $660.69 Typical High $1,318.26 | Professional | 55 · Aftercare only | $660.69 | $660.69 | $1,318.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $446.68 Median $446.68 Typical High $891.25 | Professional | 56 · Pre-op care only | $446.68 | $446.68 | $891.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,238.72 Median $2,238.72 Typical High $4,466.84 | Professional | 52 · Reduced service | $2,238.72 | $2,238.72 | $4,466.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $891.25 Median $891.25 Typical High $1,778.28 | Professional | 53 · Discontinued | $891.25 | $891.25 | $1,778.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $660.69 Typical High $1,318.26 | Professional | 55 · Aftercare only | $660.69 | $660.69 | $1,318.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $446.68 Median $446.68 Typical High $891.25 | Professional | 56 · Pre-op care only | $446.68 | $446.68 | $891.25 |
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
$5,623
MT $10,715NY $4,169
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.