How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $389.05 Median $5,888.44 Typical High $14,125.38 | Facility | None | $389.05 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $389.05 Typical High $776.25 | Professional | None | $70.79 | $389.05 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $223.87 Typical High $478.63 | Professional | None | $91.20 | $223.87 | $478.63 |
Moda Health Setting Facility Modifier None Typical Low $389.05 Median $562.34 Typical High $1,122.02 | Facility | None | $389.05 | $562.34 | $1,122.02 |
Moda Health Setting Professional Modifier None Typical Low $100.00 Median $389.05 Typical High $776.25 | Professional | None | $100.00 | $389.05 | $776.25 |
Premera BCBS Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $660.69 | Professional | None | $302.00 | $302.00 | $660.69 |
Providence Setting Facility Modifier None Typical Low $354.81 Median $512.86 Typical High $1,096.48 | Facility | None | $354.81 | $512.86 | $1,096.48 |
Providence Setting Professional Modifier None Typical Low $107.15 Median $229.09 Typical High $446.68 | Professional | None | $107.15 | $229.09 | $446.68 |
United Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $467.74 | Professional | None | $173.78 | $269.15 | $467.74 |
5 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 $35.48 Median $194.98 Typical High $389.05 | Professional | 52 · Reduced service | $35.48 | $194.98 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $77.62 Typical High $154.88 | Professional | 53 · Discontinued | $14.13 | $77.62 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $295.12 Typical High $588.84 | Professional | 54 · Surgery only | $52.48 | $295.12 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $58.88 Typical High $117.49 | Professional | 55 · Aftercare only | $10.72 | $58.88 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $38.90 Typical High $77.62 | Professional | 56 · Pre-op care only | $7.08 | $38.90 | $77.62 |
Where Alaska sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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.
Alaska· 2nd of 51
$302
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.