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 $371.54 Median $5,888.44 Typical High $14,125.38 | Facility | None | $371.54 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $371.54 Typical High $1,023.29 | Professional | None | $75.86 | $371.54 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $229.09 Typical High $575.44 | Professional | None | $81.28 | $229.09 | $575.44 |
Moda Health Setting Facility Modifier None Typical Low $363.08 Median $467.74 Typical High $1,148.15 | Facility | None | $363.08 | $467.74 | $1,148.15 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $371.54 Typical High $954.99 | Professional | None | $93.33 | $371.54 | $954.99 |
Premera BCBS Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $794.33 | Professional | None | $288.40 | $288.40 | $794.33 |
Providence Setting Facility Modifier None Typical Low $354.81 Median $501.19 Typical High $1,318.26 | Facility | None | $354.81 | $501.19 | $1,318.26 |
Providence Setting Professional Modifier None Typical Low $102.33 Median $229.09 Typical High $537.03 | Professional | None | $102.33 | $229.09 | $537.03 |
United Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $501.19 | Professional | None | $190.55 | $302.00 | $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 $35.48 Median $186.21 Typical High $457.09 | Professional | 52 · Reduced service | $35.48 | $186.21 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $75.86 Typical High $181.97 | Professional | 53 · Discontinued | $14.13 | $75.86 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $281.84 Typical High $691.83 | Professional | 54 · Surgery only | $53.70 | $281.84 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $56.23 Typical High $138.04 | Professional | 55 · Aftercare only | $10.72 | $56.23 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $37.15 Typical High $91.20 | Professional | 56 · Pre-op care only | $7.08 | $37.15 | $91.20 |
Where Alaska sits
The same service costs 3.8 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
$363
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.