How much rates vary
Facilitymedian $457 · 10th to 90th $204 to $5,888Professionalmedian $214 · 10th to 90th $49 to $1,096
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 $204.17 Median $5,888.44 Typical High $14,125.38 | Facility | None | $204.17 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $204.17 Typical High $1,096.48 | Professional | None | $37.15 | $204.17 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $354.81 Typical High $1,096.48 | Facility | None | $213.80 | $354.81 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $186.21 Typical High $489.78 | Professional | None | $42.66 | $186.21 | $489.78 |
Moda Health Setting Facility Modifier None Typical Low $60.26 Median $398.11 Typical High $1,548.82 | Facility | None | $60.26 | $398.11 | $1,548.82 |
Moda Health Setting Professional Modifier None Typical Low $51.29 Median $223.87 Typical High $1,258.93 | Professional | None | $51.29 | $223.87 | $1,258.93 |
Premera BCBS Setting Facility Modifier None Typical Low $245.47 Median $363.08 Typical High $489.78 | Facility | None | $245.47 | $363.08 | $489.78 |
Premera BCBS Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $912.01 | Professional | None | $151.36 | $151.36 | $912.01 |
Providence Setting Facility Modifier None Typical Low $213.80 Median $354.81 Typical High $1,949.84 | Facility | None | $213.80 | $354.81 | $1,949.84 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $131.83 Typical High $630.96 | Professional | None | $44.67 | $131.83 | $630.96 |
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 $39.81 Median $213.80 Typical High $588.84 | Professional | None | $39.81 | $213.80 | $588.84 |
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 $19.05 Median $102.33 Typical High $549.54 | Professional | 52 · Reduced service | $19.05 | $102.33 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $40.74 Typical High $218.78 | Professional | 53 · Discontinued | $7.59 | $40.74 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $151.36 Typical High $812.83 | Professional | 54 · Surgery only | $28.84 | $151.36 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $30.20 Typical High $162.18 | Professional | 55 · Aftercare only | $5.75 | $30.20 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $20.42 Typical High $109.65 | Professional | 56 · Pre-op care only | $3.80 | $20.42 | $109.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $107.15 Typical High $549.54 | Professional | 52 · Reduced service | $23.99 | $107.15 | $549.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $42.66 Typical High $218.78 | Professional | 53 · Discontinued | $9.55 | $42.66 | $218.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $158.49 Typical High $812.83 | Professional | 54 · Surgery only | $35.48 | $158.49 | $812.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $31.62 Typical High $162.18 | Professional | 55 · Aftercare only | $7.08 | $31.62 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $21.38 Typical High $109.65 | Professional | 56 · Pre-op care only | $4.79 | $21.38 | $109.65 |
Where Alaska sits
The same service costs 12.1 times more in New York 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.
Physician feeFacility fee
NY $2,679MD $222
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.