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 $1,995.26 Median $10,715.19 Typical High $14,125.38 | Facility | None | $1,995.26 | $10,715.19 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $1,995.26 Typical High $10,000.00 | Professional | None | $346.74 | $1,995.26 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $1,862.09 Typical High $5,888.44 | Professional | None | $489.78 | $1,862.09 | $5,888.44 |
Moda Health Setting Facility Modifier None Typical Low $1,995.26 Median $10,000.00 Typical High $16,982.44 | Facility | None | $1,995.26 | $10,000.00 | $16,982.44 |
Moda Health Setting Professional Modifier None Typical Low $354.81 Median $1,995.26 Typical High $10,000.00 | Professional | None | $354.81 | $1,995.26 | $10,000.00 |
Premera BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $8,128.31 | Professional | None | $1,479.11 | $1,479.11 | $8,128.31 |
Providence Setting Facility Modifier None Typical Low $1,905.46 Median $2,754.23 Typical High $16,595.87 | Facility | None | $1,905.46 | $2,754.23 | $16,595.87 |
Providence Setting Professional Modifier None Typical Low $512.86 Median $1,949.84 Typical High $5,370.32 | Professional | None | $512.86 | $1,949.84 | $5,370.32 |
United Setting Professional Modifier None Typical Low $954.99 Median $2,041.74 Typical High $5,248.07 | Professional | None | $954.99 | $2,041.74 | $5,248.07 |
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 $208.93 Median $1,000.00 Typical High $5,011.87 | Professional | 52 · Reduced service | $208.93 | $1,000.00 | $5,011.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $398.11 Typical High $1,995.26 | Professional | 53 · Discontinued | $83.18 | $398.11 | $1,995.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $1,479.11 Typical High $7,413.10 | Professional | 54 · Surgery only | $309.03 | $1,479.11 | $7,413.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $295.12 Typical High $1,479.11 | Professional | 55 · Aftercare only | $61.66 | $295.12 | $1,479.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $199.53 Typical High $1,000.00 | Professional | 56 · Pre-op care only | $41.69 | $199.53 | $1,000.00 |
Where Alaska sits
The same service costs 6.2 times more in Washington 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· 15th of 51
$1,995
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.