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 $77.62 Median $354.81 Typical High $912.01 | Professional | None | $77.62 | $354.81 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $213.80 Typical High $512.86 | Professional | None | $87.10 | $213.80 | $512.86 |
Moda Health Setting Facility Modifier None Typical Low $275.42 Median $954.99 Typical High $2,630.27 | Facility | None | $275.42 | $954.99 | $2,630.27 |
Moda Health Setting Professional Modifier None Typical Low $83.18 Median $416.87 Typical High $933.25 | Professional | None | $83.18 | $416.87 | $933.25 |
Premera BCBS Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $660.69 | Professional | None | $331.13 | $331.13 | $660.69 |
Providence Setting Facility Modifier None Typical Low $407.38 Median $588.84 Typical High $1,230.27 | Facility | None | $407.38 | $588.84 | $1,230.27 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $213.80 Typical High $398.11 | Professional | None | $79.43 | $213.80 | $398.11 |
United Setting Facility Modifier None Typical Low $478.63 Median $954.99 Typical High $1,174.90 | Facility | None | $478.63 | $954.99 | $1,174.90 |
United Setting Professional Modifier None Typical Low $154.88 Median $407.38 Typical High $812.83 | Professional | None | $154.88 | $407.38 | $812.83 |
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 $41.69 Median $208.93 Typical High $380.19 | Professional | 52 · Reduced service | $41.69 | $208.93 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $83.18 Typical High $154.88 | Professional | 53 · Discontinued | $16.60 | $83.18 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $316.23 Typical High $575.44 | Professional | 54 · Surgery only | $61.66 | $316.23 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $63.10 Typical High $114.82 | Professional | 55 · Aftercare only | $12.30 | $63.10 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $41.69 Typical High $75.86 | Professional | 56 · Pre-op care only | $8.32 | $41.69 | $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
$417
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.