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 $323.59 Median $5,888.44 Typical High $14,125.38 | Facility | None | $323.59 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $134.90 Typical High $416.87 | Professional | None | $60.26 | $134.90 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $141.25 Typical High $436.52 | Facility | None | $85.11 | $141.25 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $112.20 Typical High $269.15 | Professional | None | $67.61 | $112.20 | $269.15 |
Moda Health Setting Facility Modifier None Typical Low $100.00 Median $323.59 Typical High $602.56 | Facility | None | $100.00 | $323.59 | $602.56 |
Moda Health Setting Professional Modifier None Typical Low $63.10 Median $239.88 Typical High $501.19 | Professional | None | $63.10 | $239.88 | $501.19 |
Premera BCBS Setting Facility Modifier None Typical Low $87.10 Median $125.89 Typical High $177.83 | Facility | None | $87.10 | $125.89 | $177.83 |
Premera BCBS Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $354.81 | Professional | None | $263.03 | $263.03 | $354.81 |
Providence Setting Facility Modifier None Typical Low $117.49 Median $257.04 Typical High $467.74 | Facility | None | $117.49 | $257.04 | $467.74 |
Providence Setting Professional Modifier None Typical Low $63.10 Median $134.90 Typical High $218.78 | Professional | None | $63.10 | $134.90 | $218.78 |
United Setting Facility Modifier None Typical Low $478.63 Median $954.99 Typical High $1,174.90 | Facility | None | $478.63 | $954.99 | $1,174.90 |
United Setting Professional Modifier None Typical Low $89.13 Median $218.78 Typical High $436.52 | Professional | None | $89.13 | $218.78 | $436.52 |
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 $33.11 Median $162.18 Typical High $208.93 | Professional | 52 · Reduced service | $33.11 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $64.57 Typical High $83.18 | Professional | 53 · Discontinued | $13.18 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $239.88 Typical High $316.23 | Professional | 54 · Surgery only | $48.98 | $239.88 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $47.86 Typical High $63.10 | Professional | 55 · Aftercare only | $9.77 | $47.86 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $32.36 Typical High $41.69 | Professional | 56 · Pre-op care only | $6.61 | $32.36 | $41.69 |
Where Alaska sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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· 1st of 51
$263
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.