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 $275.42 Median $5,888.44 Typical High $14,125.38 | Facility | None | $275.42 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $275.42 Typical High $1,288.25 | Professional | None | $51.29 | $275.42 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $239.88 Typical High $831.76 | Professional | None | $58.88 | $239.88 | $831.76 |
Moda Health Setting Facility Modifier None Typical Low $275.42 Median $389.05 Typical High $1,862.09 | Facility | None | $275.42 | $389.05 | $1,862.09 |
Moda Health Setting Professional Modifier None Typical Low $53.70 Median $281.84 Typical High $1,288.25 | Professional | None | $53.70 | $281.84 | $1,288.25 |
Premera BCBS Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $1,000.00 | Professional | None | $186.21 | $186.21 | $1,000.00 |
Providence Setting Facility Modifier None Typical Low $257.04 Median $371.54 Typical High $1,819.70 | Facility | None | $257.04 | $371.54 | $1,819.70 |
Providence Setting Professional Modifier None Typical Low $66.07 Median $288.40 Typical High $707.95 | Professional | None | $66.07 | $288.40 | $707.95 |
United Setting Professional Modifier None Typical Low $123.03 Median $295.12 Typical High $724.44 | Professional | None | $123.03 | $295.12 | $724.44 |
5 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 $26.92 Median $134.90 Typical High $645.65 | Professional | 52 · Reduced service | $26.92 | $134.90 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $54.95 Typical High $257.04 | Professional | 53 · Discontinued | $10.72 | $54.95 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $204.17 Typical High $977.24 | Professional | 54 · Surgery only | $39.81 | $204.17 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $40.74 Typical High $194.98 | Professional | 55 · Aftercare only | $7.94 | $40.74 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $27.54 Typical High $128.82 | Professional | 56 · Pre-op care only | $5.37 | $27.54 | $128.82 |
Where Alaska sits
The same service costs 4.9 times more in Iowa than in Nebraska. 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· 16th of 51
$288
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.