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 $398.11 Median $5,888.44 Typical High $14,125.38 | Facility | None | $398.11 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $398.11 Typical High $891.25 | Professional | None | $77.62 | $398.11 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $186.21 Typical High $524.81 | Professional | None | $87.10 | $186.21 | $524.81 |
Moda Health Setting Facility Modifier None Typical Low $398.11 Median $891.25 Typical High $14,791.08 | Facility | None | $398.11 | $891.25 | $14,791.08 |
Moda Health Setting Professional Modifier None Typical Low $89.13 Median $309.03 Typical High $891.25 | Professional | None | $89.13 | $309.03 | $891.25 |
Premera BCBS Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $691.83 | Professional | None | $275.42 | $275.42 | $691.83 |
Providence Setting Facility Modifier None Typical Low $389.05 Median $549.54 Typical High $1,318.26 | Facility | None | $389.05 | $549.54 | $1,318.26 |
Providence Setting Professional Modifier None Typical Low $77.62 Median $186.21 Typical High $457.09 | Professional | None | $77.62 | $186.21 | $457.09 |
United Setting Professional Modifier None Typical Low $165.96 Median $302.00 Typical High $467.74 | Professional | None | $165.96 | $302.00 | $467.74 |
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 $39.81 Median $199.53 Typical High $446.68 | Professional | 52 · Reduced service | $39.81 | $199.53 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $79.43 Typical High $177.83 | Professional | 53 · Discontinued | $15.85 | $79.43 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $302.00 Typical High $676.08 | Professional | 54 · Surgery only | $58.88 | $302.00 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $60.26 Typical High $134.90 | Professional | 55 · Aftercare only | $11.75 | $60.26 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $39.81 Typical High $89.13 | Professional | 56 · Pre-op care only | $7.94 | $39.81 | $89.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $199.53 Typical High $446.68 | Professional | 52 · Reduced service | $42.66 | $199.53 | $446.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $79.43 Typical High $177.83 | Professional | 53 · Discontinued | $16.98 | $79.43 | $177.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $302.00 Typical High $676.08 | Professional | 54 · Surgery only | $64.57 | $302.00 | $676.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $60.26 Typical High $134.90 | Professional | 55 · Aftercare only | $12.88 | $60.26 | $134.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $39.81 Typical High $89.13 | Professional | 56 · Pre-op care only | $8.51 | $39.81 | $89.13 |
Where Alaska sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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· 3rd of 51
$288
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.