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 $281.84 Median $7,079.46 Typical High $14,125.38 | Facility | None | $281.84 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $186.21 Typical High $616.60 | Professional | None | $53.70 | $186.21 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $158.49 Typical High $380.19 | Professional | None | $64.57 | $158.49 | $380.19 |
Moda Health Setting Facility Modifier None Typical Low $281.84 Median $398.11 Typical High $891.25 | Facility | None | $281.84 | $398.11 | $891.25 |
Moda Health Setting Professional Modifier None Typical Low $54.95 Median $194.98 Typical High $616.60 | Professional | None | $54.95 | $194.98 | $616.60 |
Premera BCBS Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $467.74 | Professional | None | $190.55 | $190.55 | $467.74 |
Providence Setting Facility Modifier None Typical Low $263.03 Median $380.19 Typical High $891.25 | Facility | None | $263.03 | $380.19 | $891.25 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $162.18 Typical High $316.23 | Professional | None | $70.79 | $162.18 | $316.23 |
United Setting Professional Modifier None Typical Low $125.89 Median $208.93 Typical High $371.54 | Professional | None | $125.89 | $208.93 | $371.54 |
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 $26.92 Median $141.25 Typical High $309.03 | Professional | 52 · Reduced service | $26.92 | $141.25 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $56.23 Typical High $123.03 | Professional | 53 · Discontinued | $10.96 | $56.23 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $208.93 Typical High $467.74 | Professional | 54 · Surgery only | $40.74 | $208.93 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $41.69 Typical High $93.33 | Professional | 55 · Aftercare only | $8.13 | $41.69 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $28.18 Typical High $61.66 | Professional | 56 · Pre-op care only | $5.37 | $28.18 | $61.66 |
Where Alaska sits
The same service costs 2.8 times more in Wisconsin than in Florida. 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
$195
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.