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 $85.11 Median $85.11 Typical High $371.54 | Facility | None | $85.11 | $85.11 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $85.11 Typical High $371.54 | Professional | None | $15.14 | $85.11 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $162.18 Typical High $501.19 | Facility | None | $97.72 | $162.18 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $58.88 Typical High $251.19 | Professional | None | $16.60 | $58.88 | $251.19 |
Moda Health Setting Facility Modifier None Typical Low $25.70 Median $114.82 Typical High $524.81 | Facility | None | $25.70 | $114.82 | $524.81 |
Moda Health Setting Professional Modifier None Typical Low $16.22 Median $85.11 Typical High $371.54 | Professional | None | $16.22 | $85.11 | $371.54 |
Premera BCBS Setting Facility Modifier None Typical Low $120.23 Median $177.83 Typical High $234.42 | Facility | None | $120.23 | $177.83 | $234.42 |
Premera BCBS Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $323.59 | Professional | None | $61.66 | $61.66 | $323.59 |
Providence Setting Facility Modifier None Typical Low $97.72 Median $162.18 Typical High $501.19 | Facility | None | $97.72 | $162.18 | $501.19 |
Providence Setting Professional Modifier None Typical Low $22.39 Median $60.26 Typical High $190.55 | Professional | None | $22.39 | $60.26 | $190.55 |
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 $41.69 Median $95.50 Typical High $398.11 | Professional | None | $41.69 | $95.50 | $398.11 |
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 $7.76 Median $42.66 Typical High $186.21 | Professional | 52 · Reduced service | $7.76 | $42.66 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $16.98 Typical High $74.13 | Professional | 53 · Discontinued | $3.09 | $16.98 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $12.88 Typical High $54.95 | Professional | 55 · Aftercare only | $2.34 | $12.88 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $8.51 Typical High $37.15 | Professional | 56 · Pre-op care only | $1.55 | $8.51 | $37.15 |
Where Alaska sits
The same service costs 5.9 times more in Iowa 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· 5th of 51
$97.72
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.