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 $1,348.96 Median $6,309.57 Typical High $14,125.38 | Facility | None | $1,348.96 | $6,309.57 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $1,348.96 Typical High $6,309.57 | Professional | None | $223.87 | $1,348.96 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $1,230.27 Typical High $3,890.45 | Professional | None | $309.03 | $1,230.27 | $3,890.45 |
Moda Health Setting Facility Modifier None Typical Low $1,348.96 Median $6,309.57 Typical High $9,120.11 | Facility | None | $1,348.96 | $6,309.57 | $9,120.11 |
Moda Health Setting Professional Modifier None Typical Low $234.42 Median $1,348.96 Typical High $6,309.57 | Professional | None | $234.42 | $1,348.96 | $6,309.57 |
Premera BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $5,248.07 | Professional | None | $1,000.00 | $1,000.00 | $5,248.07 |
Providence Setting Facility Modifier None Typical Low $1,288.25 Median $1,862.09 Typical High $11,220.18 | Facility | None | $1,288.25 | $1,862.09 | $11,220.18 |
Providence Setting Professional Modifier None Typical Low $331.13 Median $1,288.25 Typical High $3,467.37 | Professional | None | $331.13 | $1,288.25 | $3,467.37 |
United Setting Professional Modifier None Typical Low $645.65 Median $1,380.38 Typical High $3,467.37 | Professional | None | $645.65 | $1,380.38 | $3,467.37 |
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 $141.25 Median $676.08 Typical High $3,162.28 | Professional | 52 · Reduced service | $141.25 | $676.08 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $269.15 Typical High $1,258.93 | Professional | 53 · Discontinued | $56.23 | $269.15 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $1,000.00 Typical High $4,677.35 | Professional | 54 · Surgery only | $208.93 | $1,000.00 | $4,677.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $199.53 Typical High $954.99 | Professional | 55 · Aftercare only | $42.66 | $199.53 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $134.90 Typical High $630.96 | Professional | 56 · Pre-op care only | $28.18 | $134.90 | $630.96 |
Where Alaska sits
The same service costs 6.5 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· 11th of 51
$1,349
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.