How much rates vary
Facilitymedian $389 · 10th to 90th $224 to $5,888Professionalmedian $195 · 10th to 90th $60 to $631
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 $257.04 Median $5,888.44 Typical High $14,125.38 | Facility | None | $257.04 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $257.04 Typical High $630.96 | Professional | None | $48.98 | $257.04 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $302.00 Typical High $933.25 | Facility | None | $181.97 | $302.00 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $131.83 Typical High $346.74 | Professional | None | $50.12 | $131.83 | $346.74 |
Moda Health Setting Facility Modifier None Typical Low $77.62 Median $371.54 Typical High $1,862.09 | Facility | None | $77.62 | $371.54 | $1,862.09 |
Moda Health Setting Professional Modifier None Typical Low $67.61 Median $257.04 Typical High $707.95 | Professional | None | $67.61 | $257.04 | $707.95 |
Premera BCBS Setting Facility Modifier None Typical Low $190.55 Median $281.84 Typical High $380.19 | Facility | None | $190.55 | $281.84 | $380.19 |
Premera BCBS Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $524.81 | Professional | None | $194.98 | $194.98 | $524.81 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $371.54 Typical High $1,096.48 | Facility | None | $251.19 | $371.54 | $1,096.48 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $134.90 Typical High $346.74 | Professional | None | $60.26 | $134.90 | $346.74 |
United Setting Facility Modifier None Typical Low $831.76 Median $1,778.28 Typical High $2,951.21 | Facility | None | $831.76 | $1,778.28 | $2,951.21 |
United Setting Professional Modifier None Typical Low $50.12 Median $128.82 Typical High $371.54 | Professional | None | $50.12 | $128.82 | $371.54 |
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 $24.55 Median $128.82 Typical High $316.23 | Professional | 52 · Reduced service | $24.55 | $128.82 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $51.29 Typical High $125.89 | Professional | 53 · Discontinued | $9.77 | $51.29 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $194.98 Typical High $478.63 | Professional | 54 · Surgery only | $37.15 | $194.98 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $38.90 Typical High $95.50 | Professional | 55 · Aftercare only | $7.41 | $38.90 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $25.70 Typical High $63.10 | Professional | 56 · Pre-op care only | $4.90 | $25.70 | $63.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $128.82 Typical High $316.23 | Professional | 52 · Reduced service | $30.90 | $128.82 | $316.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $51.29 Typical High $125.89 | Professional | 53 · Discontinued | $12.30 | $51.29 | $125.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $194.98 Typical High $478.63 | Professional | 54 · Surgery only | $45.71 | $194.98 | $478.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $38.90 Typical High $95.50 | Professional | 55 · Aftercare only | $9.12 | $38.90 | $95.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $25.70 Typical High $63.10 | Professional | 56 · Pre-op care only | $6.17 | $25.70 | $63.10 |
Where Alaska sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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
$224
AK $224DC $63.10
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.