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 $407.38 Median $407.38 Typical High $575.44 | Facility | None | $407.38 | $407.38 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $407.38 Typical High $575.44 | Professional | None | $81.28 | $407.38 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $213.80 Typical High $660.69 | Facility | None | $128.82 | $213.80 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $162.18 Typical High $389.05 | Professional | None | $85.11 | $162.18 | $389.05 |
Moda Health Setting Facility Modifier None Typical Low $123.03 Median $407.38 Typical High $831.76 | Facility | None | $123.03 | $407.38 | $831.76 |
Moda Health Setting Professional Modifier None Typical Low $112.20 Median $407.38 Typical High $724.44 | Professional | None | $112.20 | $407.38 | $724.44 |
Premera BCBS Setting Facility Modifier None Typical Low $138.04 Median $186.21 Typical High $281.84 | Facility | None | $138.04 | $186.21 | $281.84 |
Premera BCBS Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $501.19 | Professional | None | $331.13 | $331.13 | $501.19 |
Providence Setting Facility Modifier None Typical Low $177.83 Median $389.05 Typical High $676.08 | Facility | None | $177.83 | $389.05 | $676.08 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $169.82 Typical High $288.40 | Professional | None | $79.43 | $169.82 | $288.40 |
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 $117.49 Median $309.03 Typical High $616.60 | Professional | None | $117.49 | $309.03 | $616.60 |
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 $40.74 Median $204.17 Typical High $288.40 | Professional | 52 · Reduced service | $40.74 | $204.17 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $81.28 Typical High $114.82 | Professional | 53 · Discontinued | $16.22 | $81.28 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $60.26 Typical High $87.10 | Professional | 55 · Aftercare only | $12.30 | $60.26 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $40.74 Typical High $57.54 | Professional | 56 · Pre-op care only | $8.13 | $40.74 | $57.54 |
Where Alaska sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$339
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.