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 $1,412.54 Median $7,079.46 Typical High $14,125.38 | Facility | None | $1,412.54 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $1,412.54 Typical High $4,265.80 | Professional | None | $281.84 | $1,412.54 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $812.83 Typical High $2,454.71 | Professional | None | $331.13 | $812.83 | $2,454.71 |
Moda Health Setting Facility Modifier None Typical Low $1,412.54 Median $4,265.80 Typical High $11,481.54 | Facility | None | $1,412.54 | $4,265.80 | $11,481.54 |
Moda Health Setting Professional Modifier None Typical Low $295.12 Median $1,348.96 Typical High $4,265.80 | Professional | None | $295.12 | $1,348.96 | $4,265.80 |
Premera BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $3,311.31 | Professional | None | $1,000.00 | $1,000.00 | $3,311.31 |
Providence Setting Facility Modifier None Typical Low $1,348.96 Median $1,949.84 Typical High $6,025.60 | Facility | None | $1,348.96 | $1,949.84 | $6,025.60 |
Providence Setting Professional Modifier None Typical Low $363.08 Median $870.96 Typical High $2,290.87 | Professional | None | $363.08 | $870.96 | $2,290.87 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,047.13 Typical High $2,238.72 | Professional | None | $660.69 | $1,047.13 | $2,238.72 |
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 $138.04 Median $707.95 Typical High $2,137.96 | Professional | 52 · Reduced service | $138.04 | $707.95 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $281.84 Typical High $851.14 | Professional | 53 · Discontinued | $56.23 | $281.84 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $1,071.52 Typical High $3,235.94 | Professional | 54 · Surgery only | $208.93 | $1,071.52 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $213.80 Typical High $645.65 | Professional | 55 · Aftercare only | $41.69 | $213.80 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $141.25 Typical High $426.58 | Professional | 56 · Pre-op care only | $28.18 | $141.25 | $426.58 |
Where Alaska sits
The same service costs 4.3 times more in Wisconsin 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· 2nd 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.