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 $758.58 Median $9,772.37 Typical High $16,595.87 | Facility | None | $758.58 | $9,772.37 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $758.58 Typical High $1,258.93 | Professional | None | $173.78 | $758.58 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $389.05 Typical High $1,202.26 | Facility | None | $239.88 | $389.05 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $323.59 Typical High $831.76 | Professional | None | $165.96 | $323.59 | $831.76 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $758.58 Typical High $1,819.70 | Facility | None | $251.19 | $758.58 | $1,819.70 |
Moda Health Setting Professional Modifier None Typical Low $218.78 Median $758.58 Typical High $1,445.44 | Professional | None | $218.78 | $758.58 | $1,445.44 |
Premera BCBS Setting Facility Modifier None Typical Low $245.47 Median $331.13 Typical High $501.19 | Facility | None | $245.47 | $331.13 | $501.19 |
Premera BCBS Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,148.15 | Professional | None | $660.69 | $660.69 | $1,148.15 |
Providence Setting Facility Modifier None Typical Low $331.13 Median $707.95 Typical High $1,513.56 | Facility | None | $331.13 | $707.95 | $1,513.56 |
Providence Setting Professional Modifier None Typical Low $154.88 Median $363.08 Typical High $616.60 | Professional | None | $154.88 | $363.08 | $616.60 |
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 $257.04 Median $660.69 Typical High $1,318.26 | Professional | None | $257.04 | $660.69 | $1,318.26 |
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 $81.28 Median $380.19 Typical High $630.96 | Professional | 52 · Reduced service | $81.28 | $380.19 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $154.88 Typical High $251.19 | Professional | 53 · Discontinued | $32.36 | $154.88 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $575.44 Typical High $954.99 | Professional | 54 · Surgery only | $123.03 | $575.44 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $114.82 Typical High $190.55 | Professional | 55 · Aftercare only | $24.55 | $114.82 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $75.86 Typical High $125.89 | Professional | 56 · Pre-op care only | $16.22 | $75.86 | $125.89 |
Where Alaska sits
The same service costs 3.6 times more in Alaska than in Maryland. 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
$661
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.