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 $416.87 Median $5,888.44 Typical High $14,125.38 | Facility | None | $416.87 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $371.54 Typical High $1,412.54 | Professional | None | $75.86 | $371.54 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $288.40 Typical High $912.01 | Professional | None | $87.10 | $288.40 | $912.01 |
Moda Health Setting Facility Modifier None Typical Low $416.87 Median $588.84 Typical High $2,041.74 | Facility | None | $416.87 | $588.84 | $2,041.74 |
Moda Health Setting Professional Modifier None Typical Low $83.18 Median $363.08 Typical High $1,412.54 | Professional | None | $83.18 | $363.08 | $1,412.54 |
Premera BCBS Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $1,230.27 | Professional | None | $331.13 | $331.13 | $1,230.27 |
Providence Setting Facility Modifier None Typical Low $389.05 Median $549.54 Typical High $2,187.76 | Facility | None | $389.05 | $549.54 | $2,187.76 |
Providence Setting Professional Modifier None Typical Low $114.82 Median $309.03 Typical High $870.96 | Professional | None | $114.82 | $309.03 | $870.96 |
United Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $794.33 | Professional | None | $218.78 | $346.74 | $794.33 |
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 $39.81 Median $204.17 Typical High $707.95 | Professional | 52 · Reduced service | $39.81 | $204.17 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $83.18 Typical High $281.84 | Professional | 53 · Discontinued | $15.85 | $83.18 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $309.03 Typical High $1,071.52 | Professional | 54 · Surgery only | $60.26 | $309.03 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $61.66 Typical High $213.80 | Professional | 55 · Aftercare only | $12.02 | $61.66 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $41.69 Typical High $141.25 | Professional | 56 · Pre-op care only | $7.94 | $41.69 | $141.25 |
Where Alaska sits
The same service costs 4.2 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
$372
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.