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 $562.34 Median $12,022.64 Typical High $16,595.87 | Facility | None | $562.34 | $12,022.64 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $562.34 Typical High $562.34 | Professional | None | $104.71 | $562.34 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $144.54 Typical High $309.03 | Professional | None | $95.50 | $144.54 | $309.03 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $562.34 Typical High $812.83 | Facility | None | $162.18 | $562.34 | $812.83 |
Moda Health Setting Professional Modifier None Typical Low $114.82 Median $426.58 Typical High $602.56 | Professional | None | $114.82 | $426.58 | $602.56 |
Premera BCBS Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
Providence Setting Facility Modifier None Typical Low $549.54 Median $251,188.64 Typical High $346,736.85 | Facility | None | $549.54 | $251,188.64 | $346,736.85 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $147.91 Typical High $309.03 | Professional | None | $60.26 | $147.91 | $309.03 |
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 $100.00 Median $288.40 Typical High $676.08 | Professional | None | $100.00 | $288.40 | $676.08 |
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 $52.48 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $52.48 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $20.89 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $77.62 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $15.49 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $10.47 | $56.23 | $56.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $57.54 | $281.84 | $281.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $22.91 | $112.20 | $112.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $87.10 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $17.38 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $11.48 | $56.23 | $56.23 |
Where Alaska sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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
$427
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.