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 $162.18 Median $162.18 Typical High $269.15 | Facility | None | $162.18 | $162.18 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $162.18 Typical High $269.15 | Professional | None | $33.88 | $162.18 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $79.43 Typical High $173.78 | Professional | None | $33.88 | $79.43 | $173.78 |
Moda Health Setting Facility Modifier None Typical Low $47.86 Median $162.18 Typical High $380.19 | Facility | None | $47.86 | $162.18 | $380.19 |
Moda Health Setting Professional Modifier None Typical Low $39.81 Median $141.25 Typical High $269.15 | Professional | None | $39.81 | $141.25 | $269.15 |
Premera BCBS Setting Facility Modifier None Typical Low $79.43 Median $85.11 Typical High $131.83 | Facility | None | $79.43 | $85.11 | $131.83 |
Premera BCBS Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $234.42 | Professional | None | $128.82 | $128.82 | $234.42 |
Providence Setting Facility Modifier None Typical Low $151.36 Median $213.80 Typical High $398.11 | Facility | None | $151.36 | $213.80 | $398.11 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $70.79 Typical High $131.83 | Professional | None | $44.67 | $70.79 | $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 $51.29 Median $138.04 Typical High $281.84 | Professional | None | $51.29 | $138.04 | $281.84 |
4 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 $15.14 Median $81.28 Typical High $134.90 | Professional | 52 · Reduced service | $15.14 | $81.28 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $32.36 Typical High $53.70 | Professional | 53 · Discontinued | $6.17 | $32.36 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $24.55 Typical High $39.81 | Professional | 55 · Aftercare only | $4.57 | $24.55 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $16.22 Typical High $26.92 | Professional | 56 · Pre-op care only | $3.09 | $16.22 | $26.92 |
Where Alaska sits
The same service costs 3.6 times more in Alaska than in Virginia. 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
$141
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.