How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $213.80 Median $263.03 Typical High $489.78 | Facility | None | $213.80 | $263.03 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $154.88 Typical High $389.05 | Professional | None | $54.95 | $154.88 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $169.82 Typical High $512.86 | Facility | None | $102.33 | $169.82 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $107.15 Typical High $257.04 | Professional | None | $43.65 | $107.15 | $257.04 |
Moda Health Setting Facility Modifier None Typical Low $213.80 Median $389.05 Typical High $776.25 | Facility | None | $213.80 | $389.05 | $776.25 |
Moda Health Setting Professional Modifier None Typical Low $61.66 Median $213.80 Typical High $467.74 | Professional | None | $61.66 | $213.80 | $467.74 |
Premera BCBS Setting Facility Modifier None Typical Low $112.20 Median $138.04 Typical High $213.80 | Facility | None | $112.20 | $138.04 | $213.80 |
Premera BCBS Setting Professional Modifier None Typical Low $169.82 Median $346.74 Typical High $346.74 | Professional | None | $169.82 | $346.74 | $346.74 |
Providence Setting Facility Modifier None Typical Low $141.25 Median $218.78 Typical High $512.86 | Facility | None | $141.25 | $218.78 | $512.86 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $107.15 Typical High $194.98 | Professional | None | $60.26 | $107.15 | $194.98 |
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 $75.86 Median $204.17 Typical High $407.38 | Professional | None | $75.86 | $204.17 | $407.38 |
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 $27.54 Median $104.71 Typical High $194.98 | Professional | 52 · Reduced service | $27.54 | $104.71 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $42.66 Typical High $77.62 | Professional | 53 · Discontinued | $10.96 | $42.66 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $31.62 Typical High $58.88 | Professional | 55 · Aftercare only | $8.32 | $31.62 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $21.38 Typical High $38.90 | Professional | 56 · Pre-op care only | $5.50 | $21.38 | $38.90 |
Where Alaska sits
The same service costs 3.8 times more in Alaska than in Virginia. 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
$214
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.