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 $380.19 Median $380.19 Typical High $512.86 | Facility | None | $380.19 | $380.19 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $380.19 Typical High $512.86 | Professional | None | $75.86 | $380.19 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $177.83 Typical High $549.54 | Facility | None | $107.15 | $177.83 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $154.88 Typical High $338.84 | Professional | None | $79.43 | $154.88 | $338.84 |
Moda Health Setting Facility Modifier None Typical Low $114.82 Median $380.19 Typical High $724.44 | Facility | None | $114.82 | $380.19 | $724.44 |
Moda Health Setting Professional Modifier None Typical Low $97.72 Median $380.19 Typical High $630.96 | Professional | None | $97.72 | $380.19 | $630.96 |
Premera BCBS Setting Facility Modifier None Typical Low $104.71 Median $147.91 Typical High $229.09 | Facility | None | $104.71 | $147.91 | $229.09 |
Premera BCBS Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $436.52 | Professional | None | $309.03 | $309.03 | $436.52 |
Providence Setting Facility Modifier None Typical Low $147.91 Median $323.59 Typical High $588.84 | Facility | None | $147.91 | $323.59 | $588.84 |
Providence Setting Professional Modifier None Typical Low $75.86 Median $158.49 Typical High $263.03 | Professional | None | $75.86 | $158.49 | $263.03 |
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 $100.00 Median $275.42 Typical High $549.54 | Professional | None | $100.00 | $275.42 | $549.54 |
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 $38.02 Median $190.55 Typical High $257.04 | Professional | 52 · Reduced service | $38.02 | $190.55 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $75.86 Typical High $102.33 | Professional | 53 · Discontinued | $15.14 | $75.86 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $56.23 Typical High $75.86 | Professional | 55 · Aftercare only | $11.48 | $56.23 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $38.02 Typical High $51.29 | Professional | 56 · Pre-op care only | $7.59 | $38.02 | $51.29 |
Where Alaska sits
The same service costs 3.8 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
$309
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.