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 $144.54 Median $144.54 Typical High $208.93 | Facility | None | $144.54 | $144.54 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $144.54 Typical High $208.93 | Professional | None | $28.84 | $144.54 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $61.66 Typical High $186.21 | Facility | None | $37.15 | $61.66 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $74.13 Typical High $141.25 | Professional | None | $28.84 | $74.13 | $141.25 |
Moda Health Setting Facility Modifier None Typical Low $46.77 Median $144.54 Typical High $302.00 | Facility | None | $46.77 | $144.54 | $302.00 |
Moda Health Setting Professional Modifier None Typical Low $41.69 Median $141.25 Typical High $239.88 | Professional | None | $41.69 | $141.25 | $239.88 |
Premera BCBS Setting Facility Modifier None Typical Low $46.77 Median $64.57 Typical High $93.33 | Facility | None | $46.77 | $64.57 | $93.33 |
Premera BCBS Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $177.83 | Professional | None | $112.20 | $112.20 | $177.83 |
Providence Setting Facility Modifier None Typical Low $51.29 Median $109.65 Typical High $229.09 | Facility | None | $51.29 | $109.65 | $229.09 |
Providence Setting Professional Modifier None Typical Low $38.90 Median $60.26 Typical High $104.71 | Professional | None | $38.90 | $60.26 | $104.71 |
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 $44.67 Median $112.20 Typical High $229.09 | Professional | None | $44.67 | $112.20 | $229.09 |
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 $14.45 Median $72.44 Typical High $104.71 | Professional | 52 · Reduced service | $14.45 | $72.44 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $28.84 Typical High $41.69 | Professional | 53 · Discontinued | $5.75 | $28.84 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $21.88 Typical High $31.62 | Professional | 55 · Aftercare only | $4.27 | $21.88 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $14.45 Typical High $20.89 | Professional | 56 · Pre-op care only | $2.88 | $14.45 | $20.89 |
Where Alaska sits
The same service costs 3.3 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
$112
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.