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 $234.42 Median $2,511.89 Typical High $14,125.38 | Facility | None | $234.42 | $2,511.89 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $186.21 Typical High $309.03 | Professional | None | $38.90 | $186.21 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $72.44 Typical High $2,511.89 | Facility | None | $43.65 | $72.44 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $79.43 Typical High $177.83 | Professional | None | $38.90 | $79.43 | $177.83 |
Moda Health Setting Facility Modifier None Typical Low $186.21 Median $363.08 Typical High $870.96 | Facility | None | $186.21 | $363.08 | $870.96 |
Moda Health Setting Professional Modifier None Typical Low $50.12 Median $186.21 Typical High $323.59 | Professional | None | $50.12 | $186.21 | $323.59 |
Premera BCBS Setting Facility Modifier None Typical Low $61.66 Median $79.43 Typical High $125.89 | Facility | None | $61.66 | $79.43 | $125.89 |
Premera BCBS Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $213.80 | Professional | None | $147.91 | $213.80 | $213.80 |
Providence Setting Facility Modifier None Typical Low $60.26 Median $131.83 Typical High $2,511.89 | Facility | None | $60.26 | $131.83 | $2,511.89 |
Providence Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $131.83 | Professional | None | $51.29 | $75.86 | $131.83 |
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 $53.70 Median $144.54 Typical High $288.40 | Professional | None | $53.70 | $144.54 | $288.40 |
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 $18.20 Median $93.33 Typical High $128.82 | Professional | 52 · Reduced service | $18.20 | $93.33 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $37.15 Typical High $51.29 | Professional | 53 · Discontinued | $7.24 | $37.15 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $141.25 Typical High $190.55 | Professional | 54 · Surgery only | $26.92 | $141.25 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $28.18 Typical High $38.02 | Professional | 55 · Aftercare only | $5.37 | $28.18 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $18.62 Typical High $25.70 | Professional | 56 · Pre-op care only | $3.63 | $18.62 | $25.70 |
Where Alaska sits
The same service costs 4.2 times more in Alaska 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.
Alaska· 1st of 51
$186
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.