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 $257.04 Median $5,888.44 Typical High $14,125.38 | Facility | None | $257.04 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $257.04 Typical High $758.58 | Professional | None | $48.98 | $257.04 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $169.82 Typical High $478.63 | Professional | None | $56.23 | $169.82 | $478.63 |
Moda Health Setting Facility Modifier None Typical Low $323.59 Median $870.96 Typical High $1,148.15 | Facility | None | $323.59 | $870.96 | $1,148.15 |
Moda Health Setting Professional Modifier None Typical Low $64.57 Median $257.04 Typical High $758.58 | Professional | None | $64.57 | $257.04 | $758.58 |
Premera BCBS Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $660.69 | Professional | None | $199.53 | $199.53 | $660.69 |
Providence Setting Facility Modifier None Typical Low $245.47 Median $346.74 Typical High $1,096.48 | Facility | None | $245.47 | $346.74 | $1,096.48 |
Providence Setting Professional Modifier None Typical Low $69.18 Median $173.78 Typical High $457.09 | Professional | None | $69.18 | $173.78 | $457.09 |
United Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $416.87 | Professional | None | $131.83 | $213.80 | $416.87 |
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 $24.55 Median $128.82 Typical High $380.19 | Professional | 52 · Reduced service | $24.55 | $128.82 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $51.29 Typical High $151.36 | Professional | 53 · Discontinued | $9.77 | $51.29 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $194.98 Typical High $562.34 | Professional | 54 · Surgery only | $36.31 | $194.98 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $38.90 Typical High $114.82 | Professional | 55 · Aftercare only | $7.24 | $38.90 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $25.70 Typical High $75.86 | Professional | 56 · Pre-op care only | $4.90 | $25.70 | $75.86 |
Where Alaska sits
The same service costs 3.9 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
$257
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.