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 $1,949.84 Median $9,549.93 Typical High $14,125.38 | Facility | None | $1,949.84 | $9,549.93 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $2,187.76 Typical High $10,232.93 | Professional | None | $407.38 | $2,187.76 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $1,258.93 Typical High $6,025.60 | Professional | None | $537.03 | $1,258.93 | $6,025.60 |
Moda Health Setting Facility Modifier None Typical Low $2,041.74 Median $10,000.00 Typical High $14,454.40 | Facility | None | $2,041.74 | $10,000.00 | $14,454.40 |
Moda Health Setting Professional Modifier None Typical Low $812.83 Median $2,290.87 Typical High $10,232.93 | Professional | None | $812.83 | $2,290.87 | $10,232.93 |
Premera BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $7,943.28 | Professional | None | $1,380.38 | $1,380.38 | $7,943.28 |
Providence Setting Facility Modifier None Typical Low $1,949.84 Median $2,754.23 Typical High $14,125.38 | Facility | None | $1,949.84 | $2,754.23 | $14,125.38 |
Providence Setting Professional Modifier None Typical Low $575.44 Median $2,089.30 Typical High $5,623.41 | Professional | None | $575.44 | $2,089.30 | $5,623.41 |
United Setting Professional Modifier None Typical Low $912.01 Median $2,290.87 Typical High $5,495.41 | Professional | None | $912.01 | $2,290.87 | $5,495.41 |
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 $199.53 Median $1,023.29 Typical High $5,128.61 | Professional | 52 · Reduced service | $199.53 | $1,023.29 | $5,128.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $407.38 Typical High $2,041.74 | Professional | 53 · Discontinued | $79.43 | $407.38 | $2,041.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $1,513.56 Typical High $7,585.78 | Professional | 54 · Surgery only | $295.12 | $1,513.56 | $7,585.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $309.03 Typical High $1,548.82 | Professional | 55 · Aftercare only | $58.88 | $309.03 | $1,548.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $204.17 Typical High $1,023.29 | Professional | 56 · Pre-op care only | $39.81 | $204.17 | $1,023.29 |
Where Alaska sits
The same service costs 6.9 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· 10th of 51
$2,291
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.