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 $52.48 Median $257.04 Typical High $977.24 | Professional | None | $52.48 | $257.04 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $181.97 Typical High $602.56 | Professional | None | $52.48 | $181.97 | $602.56 |
Moda Health Setting Facility Modifier None Typical Low $77.62 Median $309.03 Typical High $1,380.38 | Facility | None | $77.62 | $309.03 | $1,380.38 |
Moda Health Setting Professional Modifier None Typical Low $66.07 Median $257.04 Typical High $977.24 | Professional | None | $66.07 | $257.04 | $977.24 |
Premera BCBS Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $851.14 | Professional | None | $208.93 | $208.93 | $851.14 |
Providence Setting Facility Modifier None Typical Low $245.47 Median $346.74 Typical High $1,412.54 | Facility | None | $245.47 | $346.74 | $1,412.54 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $173.78 Typical High $501.19 | Professional | None | $60.26 | $173.78 | $501.19 |
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 $138.04 Median $288.40 Typical High $977.24 | Professional | None | $138.04 | $288.40 | $977.24 |
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 $25.12 Median $128.82 Typical High $489.78 | Professional | 52 · Reduced service | $25.12 | $128.82 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $51.29 Typical High $194.98 | Professional | 53 · Discontinued | $10.00 | $51.29 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $194.98 Typical High $724.44 | Professional | 54 · Surgery only | $38.02 | $194.98 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $38.90 Typical High $144.54 | Professional | 55 · Aftercare only | $7.59 | $38.90 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $25.70 Typical High $97.72 | Professional | 56 · Pre-op care only | $5.01 | $25.70 | $97.72 |
Where Alaska sits
The same service costs 4.6 times more in Iowa than in Kentucky. 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
$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.