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 $478.63 Median $5,888.44 Typical High $14,125.38 | Facility | None | $478.63 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $263.03 Typical High $776.25 | Professional | None | $100.00 | $263.03 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $245.47 Typical High $741.31 | Facility | None | $147.91 | $245.47 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $204.17 Typical High $426.58 | Professional | None | $104.71 | $204.17 | $426.58 |
Moda Health Setting Facility Modifier None Typical Low $151.36 Median $645.65 Typical High $11,481.54 | Facility | None | $151.36 | $645.65 | $11,481.54 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $426.58 Typical High $776.25 | Professional | None | $107.15 | $426.58 | $776.25 |
Premera BCBS Setting Facility Modifier None Typical Low $165.96 Median $213.80 Typical High $331.13 | Facility | None | $165.96 | $213.80 | $331.13 |
Premera BCBS Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $562.34 | Professional | None | $398.11 | $562.34 | $562.34 |
Providence Setting Facility Modifier None Typical Low $204.17 Median $436.52 Typical High $741.31 | Facility | None | $204.17 | $436.52 | $741.31 |
Providence Setting Professional Modifier None Typical Low $95.50 Median $204.17 Typical High $323.59 | Professional | None | $95.50 | $204.17 | $323.59 |
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 $128.82 Median $338.84 Typical High $676.08 | Professional | None | $128.82 | $338.84 | $676.08 |
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 $50.12 Median $239.88 Typical High $323.59 | Professional | 52 · Reduced service | $50.12 | $239.88 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $95.50 Typical High $128.82 | Professional | 53 · Discontinued | $19.95 | $95.50 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $72.44 Typical High $95.50 | Professional | 55 · Aftercare only | $15.14 | $72.44 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $47.86 Typical High $64.57 | Professional | 56 · Pre-op care only | $10.00 | $47.86 | $64.57 |
Where Alaska sits
The same service costs 3.7 times more in Alaska than in Florida. 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
$398
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.