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 $41.69 Median $213.80 Typical High $575.44 | Professional | None | $41.69 | $213.80 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $107.15 Typical High $309.03 | Professional | None | $41.69 | $107.15 | $309.03 |
Moda Health Setting Facility Modifier None Typical Low $131.83 Median $309.03 Typical High $575.44 | Facility | None | $131.83 | $309.03 | $575.44 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $213.80 Typical High $575.44 | Professional | None | $60.26 | $213.80 | $575.44 |
Premera BCBS Setting Facility Modifier None Typical Low $85.11 Median $87.10 Typical High $131.83 | Facility | None | $85.11 | $87.10 | $131.83 |
Premera BCBS Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $478.63 | Professional | None | $165.96 | $165.96 | $478.63 |
Providence Setting Facility Modifier None Typical Low $223.87 Median $323.59 Typical High $933.25 | Facility | None | $223.87 | $323.59 | $933.25 |
Providence Setting Professional Modifier None Typical Low $48.98 Median $107.15 Typical High $309.03 | Professional | None | $48.98 | $107.15 | $309.03 |
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 $42.66 Median $107.15 Typical High $302.00 | Professional | None | $42.66 | $107.15 | $302.00 |
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 $21.38 Median $107.15 Typical High $288.40 | Professional | 52 · Reduced service | $21.38 | $107.15 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $42.66 Typical High $117.49 | Professional | 53 · Discontinued | $8.51 | $42.66 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $162.18 Typical High $436.52 | Professional | 54 · Surgery only | $31.62 | $162.18 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $32.36 Typical High $87.10 | Professional | 55 · Aftercare only | $6.31 | $32.36 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $21.38 Typical High $57.54 | Professional | 56 · Pre-op care only | $4.27 | $21.38 | $57.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $107.15 Typical High $288.40 | Professional | 52 · Reduced service | $26.30 | $107.15 | $288.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $42.66 Typical High $117.49 | Professional | 53 · Discontinued | $10.47 | $42.66 | $117.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $162.18 Typical High $436.52 | Professional | 54 · Surgery only | $38.90 | $162.18 | $436.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $32.36 Typical High $87.10 | Professional | 55 · Aftercare only | $7.76 | $32.36 | $87.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $21.38 Typical High $57.54 | Professional | 56 · Pre-op care only | $5.25 | $21.38 | $57.54 |
Where Alaska sits
The same service costs 3.4 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
$178
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.