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 $1,288.25 Median $12,022.64 Typical High $16,595.87 | Facility | None | $1,288.25 | $12,022.64 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $1,288.25 Typical High $1,288.25 | Professional | None | $239.88 | $1,288.25 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $707.95 | Professional | None | $229.09 | $331.13 | $707.95 |
Moda Health Setting Facility Modifier None Typical Low $371.54 Median $1,288.25 Typical High $1,819.70 | Facility | None | $371.54 | $1,288.25 | $1,819.70 |
Moda Health Setting Professional Modifier None Typical Low $263.03 Median $954.99 Typical High $1,380.38 | Professional | None | $263.03 | $954.99 | $1,380.38 |
Premera BCBS Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Providence Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,819.70 | Facility | None | $1,258.93 | $1,258.93 | $1,819.70 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $338.84 Typical High $707.95 | Professional | None | $60.26 | $338.84 | $707.95 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,071.52 Typical High $4,265.80 | Facility | None | $691.83 | $1,071.52 | $4,265.80 |
United Setting Professional Modifier None Typical Low $229.09 Median $660.69 Typical High $1,513.56 | Professional | None | $229.09 | $660.69 | $1,513.56 |
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 $120.23 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $120.23 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $47.86 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $177.83 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $35.48 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $23.99 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $131.83 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $52.48 | $257.04 | $257.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $199.53 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $39.81 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $26.30 | $128.82 | $128.82 |
Where Alaska sits
The same service costs 5.0 times more in Alaska 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· 1st of 51
$977
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.