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 $831.76 Median $9,772.37 Typical High $16,595.87 | Facility | None | $831.76 | $9,772.37 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $831.76 Typical High $1,348.96 | Professional | None | $177.83 | $831.76 | $1,348.96 |
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 $177.83 Median $338.84 Typical High $891.25 | Professional | None | $177.83 | $338.84 | $891.25 |
Moda Health Setting Facility Modifier None Typical Low $269.15 Median $831.76 Typical High $1,949.84 | Facility | None | $269.15 | $831.76 | $1,949.84 |
Moda Health Setting Professional Modifier None Typical Low $234.42 Median $831.76 Typical High $1,737.80 | Professional | None | $234.42 | $831.76 | $1,737.80 |
Premera BCBS Setting Facility Modifier None Typical Low $162.18 Median $323.59 Typical High $416.87 | Facility | None | $162.18 | $323.59 | $416.87 |
Premera BCBS Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,230.27 | Professional | None | $707.95 | $707.95 | $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 $165.96 Median $398.11 Typical High $660.69 | Professional | None | $165.96 | $398.11 | $660.69 |
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 $89.13 Median $416.87 Typical High $676.08 | Professional | 52 · Reduced service | $89.13 | $416.87 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $165.96 Typical High $269.15 | Professional | 53 · Discontinued | $35.48 | $165.96 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $616.60 Typical High $1,023.29 | Professional | 54 · Surgery only | $131.83 | $616.60 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $123.03 Typical High $204.17 | Professional | 55 · Aftercare only | $26.30 | $123.03 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $83.18 Typical High $134.90 | Professional | 56 · Pre-op care only | $17.78 | $83.18 | $134.90 |
Where Alaska sits
The same service costs 4.0 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
$724
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.