How much rates vary
Facilitymedian $275 · 10th to 90th $102 to $5,888Professionalmedian $234 · 10th to 90th $66 to $380
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 $309.03 Median $5,888.44 Typical High $14,125.38 | Facility | None | $309.03 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $309.03 Typical High $380.19 | Professional | None | $60.26 | $309.03 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $123.03 Typical High $380.19 | Facility | None | $74.13 | $123.03 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $89.13 Typical High $229.09 | Professional | None | $57.54 | $89.13 | $229.09 |
Moda Health Setting Facility Modifier None Typical Low $89.13 Median $309.03 Typical High $549.54 | Facility | None | $89.13 | $309.03 | $549.54 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $251.19 Typical High $389.05 | Professional | None | $74.13 | $251.19 | $389.05 |
Premera BCBS Setting Facility Modifier None Typical Low $100.00 Median $147.91 Typical High $213.80 | Facility | None | $100.00 | $147.91 | $213.80 |
Premera BCBS Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $302.00 | Professional | None | $239.88 | $239.88 | $302.00 |
Providence Setting Facility Modifier None Typical Low $102.33 Median $223.87 Typical High $588.84 | Facility | None | $102.33 | $223.87 | $588.84 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $112.20 Typical High $218.78 | Professional | None | $60.26 | $112.20 | $218.78 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $3,162.28 Typical High $4,265.80 | Facility | None | $1,096.48 | $3,162.28 | $4,265.80 |
United Setting Professional Modifier None Typical Low $58.88 Median $151.36 Typical High $416.87 | Professional | None | $58.88 | $151.36 | $416.87 |
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 $30.20 Median $154.88 Typical High $190.55 | Professional | 52 · Reduced service | $30.20 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $61.66 Typical High $75.86 | Professional | 53 · Discontinued | $12.02 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $229.09 Typical High $288.40 | Professional | 54 · Surgery only | $44.67 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $45.71 Typical High $57.54 | Professional | 55 · Aftercare only | $8.91 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $30.90 Typical High $38.02 | Professional | 56 · Pre-op care only | $6.03 | $30.90 | $38.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $154.88 Typical High $190.55 | Professional | 52 · Reduced service | $36.31 | $154.88 | $190.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $61.66 Typical High $77.62 | Professional | 53 · Discontinued | $14.45 | $61.66 | $77.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $229.09 Typical High $288.40 | Professional | 54 · Surgery only | $53.70 | $229.09 | $288.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $45.71 Typical High $57.54 | Professional | 55 · Aftercare only | $10.96 | $45.71 | $57.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $30.90 Typical High $38.02 | Professional | 56 · Pre-op care only | $7.24 | $30.90 | $38.02 |
Where Alaska sits
The same service costs 4.3 times more in Alaska than in New Jersey. 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
$240
AK $240NJ $56.23
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.