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 $1,318.26 Median $7,079.46 Typical High $14,125.38 | Facility | None | $1,318.26 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $1,318.26 Typical High $6,309.57 | Professional | None | $257.04 | $1,318.26 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $831.76 Typical High $3,715.35 | Professional | None | $302.00 | $831.76 | $3,715.35 |
Moda Health Setting Facility Modifier None Typical Low $1,318.26 Median $6,309.57 Typical High $9,549.93 | Facility | None | $1,318.26 | $6,309.57 | $9,549.93 |
Moda Health Setting Professional Modifier None Typical Low $269.15 Median $1,318.26 Typical High $6,309.57 | Professional | None | $269.15 | $1,318.26 | $6,309.57 |
Premera BCBS Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $4,897.79 | Professional | None | $933.25 | $933.25 | $4,897.79 |
Providence Setting Facility Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $8,912.51 | Facility | None | $1,288.25 | $1,819.70 | $8,912.51 |
Providence Setting Professional Modifier None Typical Low $323.59 Median $1,288.25 Typical High $3,467.37 | Professional | None | $323.59 | $1,288.25 | $3,467.37 |
United Setting Professional Modifier None Typical Low $616.60 Median $1,380.38 Typical High $3,311.31 | Professional | None | $616.60 | $1,380.38 | $3,311.31 |
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 $131.83 Median $660.69 Typical High $3,162.28 | Professional | 52 · Reduced service | $131.83 | $660.69 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $269.15 Typical High $1,258.93 | Professional | 53 · Discontinued | $52.48 | $269.15 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $1,000.00 Typical High $4,677.35 | Professional | 54 · Surgery only | $199.53 | $1,000.00 | $4,677.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $199.53 Typical High $954.99 | Professional | 55 · Aftercare only | $39.81 | $199.53 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $131.83 Typical High $630.96 | Professional | 56 · Pre-op care only | $26.30 | $131.83 | $630.96 |
Where Alaska sits
The same service costs 5.8 times more in Washington than in Hawaii. 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· 9th 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.