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 $323.59 Median $323.59 Typical High $457.09 | Facility | None | $323.59 | $323.59 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $173.78 Typical High $457.09 | Professional | None | $69.18 | $173.78 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $190.55 Typical High $588.84 | Facility | None | $114.82 | $190.55 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $144.54 Typical High $295.12 | Professional | None | $70.79 | $144.54 | $295.12 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $407.38 Typical High $645.65 | Facility | None | $104.71 | $407.38 | $645.65 |
Moda Health Setting Professional Modifier None Typical Low $81.28 Median $269.15 Typical High $549.54 | Professional | None | $81.28 | $269.15 | $549.54 |
Premera BCBS Setting Facility Modifier None Typical Low $125.89 Median $165.96 Typical High $251.19 | Facility | None | $125.89 | $165.96 | $251.19 |
Premera BCBS Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $398.11 | Professional | None | $275.42 | $398.11 | $398.11 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $331.13 Typical High $588.84 | Facility | None | $158.49 | $331.13 | $588.84 |
Providence Setting Professional Modifier None Typical Low $64.57 Median $141.25 Typical High $223.87 | Professional | None | $64.57 | $141.25 | $223.87 |
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 $89.13 Median $234.42 Typical High $478.63 | Professional | None | $89.13 | $234.42 | $478.63 |
4 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 $34.67 Median $162.18 Typical High $223.87 | Professional | 52 · Reduced service | $34.67 | $162.18 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $64.57 Typical High $91.20 | Professional | 53 · Discontinued | $13.80 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $48.98 Typical High $67.61 | Professional | 55 · Aftercare only | $10.47 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $32.36 Typical High $45.71 | Professional | 56 · Pre-op care only | $6.92 | $32.36 | $45.71 |
Where Alaska sits
The same service costs 3.6 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
$275
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.