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 $707.95 Median $7,079.46 Typical High $14,125.38 | Facility | None | $707.95 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $707.95 Typical High $2,884.03 | Professional | None | $138.04 | $707.95 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $436.52 Typical High $1,621.81 | Professional | None | $165.96 | $436.52 | $1,621.81 |
Moda Health Setting Facility Modifier None Typical Low $707.95 Median $1,023.29 Typical High $4,073.80 | Facility | None | $707.95 | $1,023.29 | $4,073.80 |
Moda Health Setting Professional Modifier None Typical Low $288.40 Median $707.95 Typical High $2,884.03 | Professional | None | $288.40 | $707.95 | $2,884.03 |
Premera BCBS Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $2,187.76 | Professional | None | $489.78 | $489.78 | $2,187.76 |
Providence Setting Facility Modifier None Typical Low $676.08 Median $954.99 Typical High $4,073.80 | Facility | None | $676.08 | $954.99 | $4,073.80 |
Providence Setting Professional Modifier None Typical Low $177.83 Median $537.03 Typical High $1,548.82 | Professional | None | $177.83 | $537.03 | $1,548.82 |
United Setting Professional Modifier None Typical Low $323.59 Median $616.60 Typical High $1,412.54 | Professional | None | $323.59 | $616.60 | $1,412.54 |
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 $69.18 Median $354.81 Typical High $1,445.44 | Professional | 52 · Reduced service | $69.18 | $354.81 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $141.25 Typical High $575.44 | Professional | 53 · Discontinued | $27.54 | $141.25 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $537.03 Typical High $2,137.96 | Professional | 54 · Surgery only | $102.33 | $537.03 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $107.15 Typical High $426.58 | Professional | 55 · Aftercare only | $20.89 | $107.15 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $70.79 Typical High $288.40 | Professional | 56 · Pre-op care only | $13.80 | $70.79 | $288.40 |
Where Alaska sits
The same service costs 4.0 times more in Wisconsin 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· 4th of 51
$708
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.