How much rates vary
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 $302.00 Median $2,511.89 Typical High $14,125.38 | Facility | None | $302.00 | $2,511.89 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $302.00 Typical High $575.44 | Professional | None | $63.10 | $302.00 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $165.96 Typical High $501.19 | Facility | None | $100.00 | $165.96 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $131.83 Typical High $302.00 | Professional | None | $63.10 | $131.83 | $302.00 |
Moda Health Setting Facility Modifier None Typical Low $204.17 Median $676.08 Typical High $1,621.81 | Facility | None | $204.17 | $676.08 | $1,621.81 |
Moda Health Setting Professional Modifier None Typical Low $75.86 Median $295.12 Typical High $575.44 | Professional | None | $75.86 | $295.12 | $575.44 |
Premera BCBS Setting Facility Modifier None Typical Low $104.71 Median $151.36 Typical High $204.17 | Facility | None | $104.71 | $151.36 | $204.17 |
Premera BCBS Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $407.38 | Professional | None | $239.88 | $239.88 | $407.38 |
Providence Setting Facility Modifier None Typical Low $138.04 Median $281.84 Typical High $524.81 | Facility | None | $138.04 | $281.84 | $524.81 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $123.03 Typical High $239.88 | Professional | None | $60.26 | $123.03 | $239.88 |
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 $239.88 Typical High $489.78 | Professional | None | $89.13 | $239.88 | $489.78 |
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 $28.84 Median $151.36 Typical High $239.88 | Professional | 52 · Reduced service | $28.84 | $151.36 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $60.26 Typical High $95.50 | Professional | 53 · Discontinued | $11.75 | $60.26 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $223.87 Typical High $354.81 | Professional | 54 · Surgery only | $43.65 | $223.87 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $45.71 Typical High $70.79 | Professional | 55 · Aftercare only | $8.71 | $45.71 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $30.20 Typical High $47.86 | Professional | 56 · Pre-op care only | $5.75 | $30.20 | $47.86 |
Where Alaska sits
The same service costs 3.7 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
$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.