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 $229.09 Median $5,888.44 Typical High $14,125.38 | Facility | None | $229.09 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $229.09 Typical High $977.24 | Professional | None | $43.65 | $229.09 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $158.49 Typical High $645.65 | Professional | None | $46.77 | $158.49 | $645.65 |
Moda Health Setting Facility Modifier None Typical Low $229.09 Median $323.59 Typical High $1,380.38 | Facility | None | $229.09 | $323.59 | $1,380.38 |
Moda Health Setting Professional Modifier None Typical Low $104.71 Median $229.09 Typical High $977.24 | Professional | None | $104.71 | $229.09 | $977.24 |
Premera BCBS Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $851.14 | Professional | None | $177.83 | $177.83 | $851.14 |
Providence Setting Facility Modifier None Typical Low $213.80 Median $309.03 Typical High $1,479.11 | Facility | None | $213.80 | $309.03 | $1,479.11 |
Providence Setting Professional Modifier None Typical Low $61.66 Median $213.80 Typical High $602.56 | Professional | None | $61.66 | $213.80 | $602.56 |
United Setting Professional Modifier None Typical Low $117.49 Median $223.87 Typical High $549.54 | Professional | None | $117.49 | $223.87 | $549.54 |
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 $21.88 Median $114.82 Typical High $489.78 | Professional | 52 · Reduced service | $21.88 | $114.82 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $45.71 Typical High $194.98 | Professional | 53 · Discontinued | $8.71 | $45.71 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $169.82 Typical High $724.44 | Professional | 54 · Surgery only | $33.11 | $169.82 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $33.88 Typical High $144.54 | Professional | 55 · Aftercare only | $6.61 | $33.88 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $22.91 Typical High $97.72 | Professional | 56 · Pre-op care only | $4.37 | $22.91 | $97.72 |
Where Alaska sits
The same service costs 5.8 times more in Washington 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· 5th of 51
$229
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.