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 $338.84 Median $5,888.44 Typical High $14,125.38 | Facility | None | $338.84 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $229.09 Typical High $891.25 | Professional | None | $63.10 | $229.09 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $223.87 Typical High $562.34 | Professional | None | $74.13 | $223.87 | $562.34 |
Moda Health Setting Facility Modifier None Typical Low $338.84 Median $489.78 Typical High $1,258.93 | Facility | None | $338.84 | $489.78 | $1,258.93 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $275.42 Typical High $891.25 | Professional | None | $69.18 | $275.42 | $891.25 |
Premera BCBS Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $758.58 | Professional | None | $263.03 | $263.03 | $758.58 |
Providence Setting Facility Modifier None Typical Low $323.59 Median $457.09 Typical High $1,288.25 | Facility | None | $323.59 | $457.09 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $93.33 Median $223.87 Typical High $524.81 | Professional | None | $93.33 | $223.87 | $524.81 |
United Setting Professional Modifier None Typical Low $173.78 Median $288.40 Typical High $501.19 | Professional | None | $173.78 | $288.40 | $501.19 |
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 $32.36 Median $169.82 Typical High $446.68 | Professional | 52 · Reduced service | $32.36 | $169.82 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $69.18 Typical High $177.83 | Professional | 53 · Discontinued | $12.88 | $69.18 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $257.04 Typical High $660.69 | Professional | 54 · Surgery only | $48.98 | $257.04 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $51.29 Typical High $131.83 | Professional | 55 · Aftercare only | $9.77 | $51.29 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $33.88 Typical High $89.13 | Professional | 56 · Pre-op care only | $6.46 | $33.88 | $89.13 |
Where Alaska sits
The same service costs 3.5 times more in North Carolina than in Indiana. 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· 3rd of 51
$288
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.