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 $776.25 Median $7,079.46 Typical High $14,125.38 | Facility | None | $776.25 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $776.25 Typical High $3,019.95 | Professional | None | $151.36 | $776.25 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $478.63 Typical High $1,737.80 | Professional | None | $190.55 | $478.63 | $1,737.80 |
Moda Health Setting Facility Modifier None Typical Low $776.25 Median $1,122.02 Typical High $4,265.80 | Facility | None | $776.25 | $1,122.02 | $4,265.80 |
Moda Health Setting Professional Modifier None Typical Low $165.96 Median $758.58 Typical High $3,019.95 | Professional | None | $165.96 | $758.58 | $3,019.95 |
Premera BCBS Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $2,344.23 | Professional | None | $549.54 | $549.54 | $2,344.23 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $1,071.52 Typical High $4,265.80 | Facility | None | $741.31 | $1,071.52 | $4,265.80 |
Providence Setting Professional Modifier None Typical Low $208.93 Median $630.96 Typical High $1,659.59 | Professional | None | $208.93 | $630.96 | $1,659.59 |
United Setting Professional Modifier None Typical Low $363.08 Median $676.08 Typical High $1,479.11 | Professional | None | $363.08 | $676.08 | $1,479.11 |
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 $77.62 Median $389.05 Typical High $1,513.56 | Professional | 52 · Reduced service | $77.62 | $389.05 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $154.88 Typical High $602.56 | Professional | 53 · Discontinued | $30.90 | $154.88 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $588.84 Typical High $2,238.72 | Professional | 54 · Surgery only | $114.82 | $588.84 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $117.49 Typical High $457.09 | Professional | 55 · Aftercare only | $23.44 | $117.49 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $77.62 Typical High $302.00 | Professional | 56 · Pre-op care only | $15.49 | $77.62 | $302.00 |
Where Alaska sits
The same service costs 3.8 times more in Wisconsin 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· 4th of 51
$776
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.