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 $1,148.15 Median $7,079.46 Typical High $14,125.38 | Facility | None | $1,148.15 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $1,148.15 Typical High $4,168.69 | Professional | None | $208.93 | $1,148.15 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $831.76 Typical High $2,454.71 | Professional | None | $275.42 | $831.76 | $2,454.71 |
Moda Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,659.59 Typical High $5,888.44 | Facility | None | $1,148.15 | $1,659.59 | $5,888.44 |
Moda Health Setting Professional Modifier None Typical Low $489.78 Median $1,148.15 Typical High $4,168.69 | Professional | None | $489.78 | $1,148.15 | $4,168.69 |
Premera BCBS Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $3,311.31 | Professional | None | $831.76 | $831.76 | $3,311.31 |
Providence Setting Facility Modifier None Typical Low $1,122.02 Median $4,168.69 Typical High $35,481.34 | Facility | None | $1,122.02 | $4,168.69 | $35,481.34 |
Providence Setting Professional Modifier None Typical Low $295.12 Median $891.25 Typical High $2,344.23 | Professional | None | $295.12 | $891.25 | $2,344.23 |
United Setting Professional Modifier None Typical Low $549.54 Median $1,202.26 Typical High $2,137.96 | Professional | None | $549.54 | $1,202.26 | $2,137.96 |
5 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 $104.71 Median $575.44 Typical High $2,041.74 | Professional | 52 · Reduced service | $104.71 | $575.44 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $229.09 Typical High $831.76 | Professional | 53 · Discontinued | $41.69 | $229.09 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $870.96 Typical High $3,090.30 | Professional | 54 · Surgery only | $158.49 | $870.96 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $173.78 Typical High $616.60 | Professional | 55 · Aftercare only | $31.62 | $173.78 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $114.82 Typical High $416.87 | Professional | 56 · Pre-op care only | $20.89 | $114.82 | $416.87 |
Where Alaska sits
The same service costs 5.4 times more in Wisconsin 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.
Alaska· 4th of 51
$1,148
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.