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 $239.88 Median $9,772.37 Typical High $16,595.87 | Facility | None | $239.88 | $9,772.37 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $239.88 Typical High $354.81 | Professional | None | $54.95 | $239.88 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $154.88 Typical High $478.63 | Facility | None | $95.50 | $154.88 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $114.82 Typical High $239.88 | Professional | None | $51.29 | $114.82 | $239.88 |
Moda Health Setting Facility Modifier None Typical Low $77.62 Median $239.88 Typical High $512.86 | Facility | None | $77.62 | $239.88 | $512.86 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $229.09 Typical High $426.58 | Professional | None | $69.18 | $229.09 | $426.58 |
Premera BCBS Setting Facility Modifier None Typical Low $107.15 Median $138.04 Typical High $229.09 | Facility | None | $107.15 | $138.04 | $229.09 |
Premera BCBS Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $316.23 | Professional | None | $199.53 | $199.53 | $316.23 |
Providence Setting Facility Modifier None Typical Low $128.82 Median $239.88 Typical High $478.63 | Facility | None | $128.82 | $239.88 | $478.63 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $107.15 Typical High $173.78 | Professional | None | $60.26 | $107.15 | $173.78 |
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 $72.44 Median $194.98 Typical High $389.05 | Professional | None | $72.44 | $194.98 | $389.05 |
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 $25.12 Median $120.23 Typical High $177.83 | Professional | 52 · Reduced service | $25.12 | $120.23 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $47.86 Typical High $70.79 | Professional | 53 · Discontinued | $10.00 | $47.86 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $177.83 Typical High $269.15 | Professional | 54 · Surgery only | $38.02 | $177.83 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $35.48 Typical High $53.70 | Professional | 55 · Aftercare only | $7.59 | $35.48 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $23.99 Typical High $35.48 | Professional | 56 · Pre-op care only | $5.01 | $23.99 | $35.48 |
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
$204
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.