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 $870.96 Median $9,772.37 Typical High $16,595.87 | Facility | None | $870.96 | $9,772.37 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $870.96 Typical High $1,380.38 | Professional | None | $181.97 | $870.96 | $1,380.38 |
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 $186.21 Median $416.87 Typical High $891.25 | Professional | None | $186.21 | $416.87 | $891.25 |
Moda Health Setting Facility Modifier None Typical Low $281.84 Median $870.96 Typical High $1,949.84 | Facility | None | $281.84 | $870.96 | $1,949.84 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $870.96 Typical High $1,737.80 | Professional | None | $245.47 | $870.96 | $1,737.80 |
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 $741.31 Median $741.31 Typical High $1,230.27 | Professional | None | $741.31 | $741.31 | $1,230.27 |
Providence Setting Facility Modifier None Typical Low $331.13 Median $707.95 Typical High $1,621.81 | Facility | None | $331.13 | $707.95 | $1,621.81 |
Providence Setting Professional Modifier None Typical Low $173.78 Median $398.11 Typical High $676.08 | Professional | None | $173.78 | $398.11 | $676.08 |
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 $269.15 Median $707.95 Typical High $1,412.54 | Professional | None | $269.15 | $707.95 | $1,412.54 |
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 $91.20 Median $436.52 Typical High $676.08 | Professional | 52 · Reduced service | $91.20 | $436.52 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $173.78 Typical High $275.42 | Professional | 53 · Discontinued | $36.31 | $173.78 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $645.65 Typical High $1,023.29 | Professional | 54 · Surgery only | $138.04 | $645.65 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $128.82 Typical High $204.17 | Professional | 55 · Aftercare only | $27.54 | $128.82 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $87.10 Typical High $138.04 | Professional | 56 · Pre-op care only | $18.20 | $87.10 | $138.04 |
Where Alaska sits
The same service costs 4.0 times more in Alaska 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· 1st of 51
$741
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.