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 $891.25 Median $9,772.37 Typical High $16,595.87 | Facility | None | $891.25 | $9,772.37 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $891.25 Typical High $1,445.44 | Professional | None | $190.55 | $891.25 | $1,445.44 |
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 $194.98 Median $426.58 Typical High $954.99 | Professional | None | $194.98 | $426.58 | $954.99 |
Moda Health Setting Facility Modifier None Typical Low $295.12 Median $891.25 Typical High $2,089.30 | Facility | None | $295.12 | $891.25 | $2,089.30 |
Moda Health Setting Professional Modifier None Typical Low $257.04 Median $891.25 Typical High $1,862.09 | Professional | None | $257.04 | $891.25 | $1,862.09 |
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 $758.58 Median $758.58 Typical High $1,318.26 | Professional | None | $758.58 | $758.58 | $1,318.26 |
Providence Setting Facility Modifier None Typical Low $331.13 Median $707.95 Typical High $1,737.80 | Facility | None | $331.13 | $707.95 | $1,737.80 |
Providence Setting Professional Modifier None Typical Low $177.83 Median $426.58 Typical High $724.44 | Professional | None | $177.83 | $426.58 | $724.44 |
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 $288.40 Median $758.58 Typical High $1,513.56 | Professional | None | $288.40 | $758.58 | $1,513.56 |
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 $95.50 Median $446.68 Typical High $724.44 | Professional | 52 · Reduced service | $95.50 | $446.68 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $177.83 Typical High $295.12 | Professional | 53 · Discontinued | $38.02 | $177.83 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $676.08 Typical High $1,096.48 | Professional | 54 · Surgery only | $144.54 | $676.08 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $134.90 Typical High $218.78 | Professional | 55 · Aftercare only | $28.84 | $134.90 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $89.13 Typical High $144.54 | Professional | 56 · Pre-op care only | $19.05 | $89.13 | $144.54 |
Where Alaska sits
The same service costs 3.8 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
$759
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.