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 $575.44 Median $6,606.93 Typical High $16,595.87 | Facility | None | $575.44 | $6,606.93 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $575.44 Typical High $870.96 | Professional | None | $104.71 | $575.44 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $134.90 Typical High $338.84 | Professional | None | $93.33 | $134.90 | $338.84 |
Moda Health Setting Facility Modifier None Typical Low $154.88 Median $575.44 Typical High $812.83 | Facility | None | $154.88 | $575.44 | $812.83 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $338.84 Typical High $575.44 | Professional | None | $107.15 | $338.84 | $575.44 |
Premera BCBS Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $758.58 Typical High $10,964.78 | Facility | None | $537.03 | $758.58 | $10,964.78 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $144.54 Typical High $288.40 | Professional | None | $60.26 | $144.54 | $288.40 |
United Setting Facility Modifier None Typical Low $478.63 Median $954.99 Typical High $1,174.90 | Facility | None | $478.63 | $954.99 | $1,174.90 |
United Setting Professional Modifier None Typical Low $89.13 Median $288.40 Typical High $302.00 | Professional | None | $89.13 | $288.40 | $302.00 |
10 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 $52.48 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $52.48 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $21.38 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $79.43 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $15.85 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $10.47 | $57.54 | $57.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $53.70 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $21.38 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $79.43 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $15.85 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $10.72 | $57.54 | $57.54 |
Where Alaska sits
The same service costs 4.0 times more in Alaska 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· 1st of 51
$372
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.