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 $95.50 Median $95.50 Typical High $169.82 | Facility | None | $95.50 | $95.50 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $64.57 Typical High $169.82 | Professional | None | $18.20 | $64.57 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $19.05 Median $52.48 Typical High $112.20 | Professional | None | $19.05 | $52.48 | $112.20 |
Moda Health Setting Facility Modifier None Typical Low $29.51 Median $95.50 Typical High $239.88 | Facility | None | $29.51 | $95.50 | $239.88 |
Moda Health Setting Professional Modifier None Typical Low $33.11 Median $91.20 Typical High $169.82 | Professional | None | $33.11 | $91.20 | $169.82 |
Premera BCBS Setting Facility Modifier None Typical Low $79.43 Median $91.20 Typical High $141.25 | Facility | None | $79.43 | $91.20 | $141.25 |
Premera BCBS Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $141.25 | Professional | None | $72.44 | $72.44 | $141.25 |
Providence Setting Facility Modifier None Typical Low $91.20 Median $131.83 Typical High $257.04 | Facility | None | $91.20 | $131.83 | $257.04 |
Providence Setting Professional Modifier None Typical Low $26.30 Median $48.98 Typical High $87.10 | Professional | None | $26.30 | $48.98 | $87.10 |
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 $40.74 Median $91.20 Typical High $181.97 | Professional | None | $40.74 | $91.20 | $181.97 |
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 $11.48 Median $47.86 Typical High $85.11 | Professional | 52 · Reduced service | $11.48 | $47.86 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $19.50 Typical High $33.88 | Professional | 53 · Discontinued | $4.68 | $19.50 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $14.45 Typical High $25.12 | Professional | 55 · Aftercare only | $3.47 | $14.45 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $9.55 Typical High $16.98 | Professional | 56 · Pre-op care only | $2.29 | $9.55 | $16.98 |
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
$91.20
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.