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 $213.80 Median $5,888.44 Typical High $14,125.38 | Facility | None | $213.80 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $213.80 Typical High $794.33 | Professional | None | $40.74 | $213.80 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $128.82 Typical High $436.52 | Professional | None | $41.69 | $128.82 | $436.52 |
Moda Health Setting Facility Modifier None Typical Low $63.10 Median $251.19 Typical High $1,122.02 | Facility | None | $63.10 | $251.19 | $1,122.02 |
Moda Health Setting Professional Modifier None Typical Low $100.00 Median $213.80 Typical High $794.33 | Professional | None | $100.00 | $213.80 | $794.33 |
Premera BCBS Setting Facility Modifier None Typical Low $114.82 Median $181.97 Typical High $281.84 | Facility | None | $114.82 | $181.97 | $281.84 |
Premera BCBS Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $660.69 | Professional | None | $165.96 | $165.96 | $660.69 |
Providence Setting Facility Modifier None Typical Low $213.80 Median $309.03 Typical High $1,230.27 | Facility | None | $213.80 | $309.03 | $1,230.27 |
Providence Setting Professional Modifier None Typical Low $48.98 Median $128.82 Typical High $446.68 | Professional | None | $48.98 | $128.82 | $446.68 |
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 $41.69 Median $147.91 Typical High $416.87 | Professional | None | $41.69 | $147.91 | $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 $20.42 Median $104.71 Typical High $398.11 | Professional | 52 · Reduced service | $20.42 | $104.71 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $42.66 Typical High $158.49 | Professional | 53 · Discontinued | $8.13 | $42.66 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $158.49 Typical High $588.84 | Professional | 54 · Surgery only | $30.20 | $158.49 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $31.62 Typical High $117.49 | Professional | 55 · Aftercare only | $6.17 | $31.62 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $21.38 Typical High $79.43 | Professional | 56 · Pre-op care only | $4.07 | $21.38 | $79.43 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $104.71 Typical High $398.11 | Professional | 52 · Reduced service | $25.70 | $104.71 | $398.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $42.66 Typical High $158.49 | Professional | 53 · Discontinued | $10.23 | $42.66 | $158.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $158.49 Typical High $588.84 | Professional | 54 · Surgery only | $38.02 | $158.49 | $588.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $31.62 Typical High $117.49 | Professional | 55 · Aftercare only | $7.59 | $31.62 | $117.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $21.38 Typical High $79.43 | Professional | 56 · Pre-op care only | $5.13 | $21.38 | $79.43 |
Where Alaska sits
The same service costs 4.6 times more in Wisconsin 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· 3rd of 51
$214
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.