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 $346.74 Median $5,888.44 Typical High $14,125.38 | Facility | None | $346.74 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $346.74 Typical High $794.33 | Professional | None | $61.66 | $346.74 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $190.55 Typical High $501.19 | Professional | None | $74.13 | $190.55 | $501.19 |
Moda Health Setting Facility Modifier None Typical Low $346.74 Median $489.78 Typical High $1,122.02 | Facility | None | $346.74 | $489.78 | $1,122.02 |
Moda Health Setting Professional Modifier None Typical Low $128.82 Median $346.74 Typical High $794.33 | Professional | None | $128.82 | $346.74 | $794.33 |
Premera BCBS Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $616.60 | Professional | None | $245.47 | $245.47 | $616.60 |
Providence Setting Facility Modifier None Typical Low $323.59 Median $467.74 Typical High $1,122.02 | Facility | None | $323.59 | $467.74 | $1,122.02 |
Providence Setting Professional Modifier None Typical Low $87.10 Median $190.55 Typical High $426.58 | Professional | None | $87.10 | $190.55 | $426.58 |
United Setting Professional Modifier None Typical Low $158.49 Median $257.04 Typical High $398.11 | Professional | None | $158.49 | $257.04 | $398.11 |
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 $30.90 Median $173.78 Typical High $398.11 | Professional | 52 · Reduced service | $30.90 | $173.78 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $69.18 Typical High $158.49 | Professional | 53 · Discontinued | $12.30 | $69.18 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $257.04 Typical High $588.84 | Professional | 54 · Surgery only | $45.71 | $257.04 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $51.29 Typical High $117.49 | Professional | 55 · Aftercare only | $9.12 | $51.29 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $34.67 Typical High $79.43 | Professional | 56 · Pre-op care only | $6.17 | $34.67 | $79.43 |
Where Alaska sits
The same service costs 3.7 times more in Wisconsin than in Maryland. 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
$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.