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 $208.93 Median $5,888.44 Typical High $14,125.38 | Facility | None | $208.93 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $208.93 Typical High $891.25 | Professional | None | $37.15 | $208.93 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $134.90 Typical High $537.03 | Professional | None | $53.70 | $134.90 | $537.03 |
Moda Health Setting Facility Modifier None Typical Low $208.93 Median $295.12 Typical High $1,288.25 | Facility | None | $208.93 | $295.12 | $1,288.25 |
Moda Health Setting Professional Modifier None Typical Low $42.66 Median $208.93 Typical High $891.25 | Professional | None | $42.66 | $208.93 | $891.25 |
Premera BCBS Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $724.44 | Professional | None | $147.91 | $147.91 | $724.44 |
Providence Setting Facility Modifier None Typical Low $199.53 Median $288.40 Typical High $1,258.93 | Facility | None | $199.53 | $288.40 | $1,258.93 |
Providence Setting Professional Modifier None Typical Low $56.23 Median $190.55 Typical High $512.86 | Professional | None | $56.23 | $190.55 | $512.86 |
United Setting Professional Modifier None Typical Low $97.72 Median $213.80 Typical High $457.09 | Professional | None | $97.72 | $213.80 | $457.09 |
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 $18.62 Median $104.71 Typical High $446.68 | Professional | 52 · Reduced service | $18.62 | $104.71 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $41.69 Typical High $177.83 | Professional | 53 · Discontinued | $7.59 | $41.69 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $154.88 Typical High $660.69 | Professional | 54 · Surgery only | $28.18 | $154.88 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $30.90 Typical High $134.90 | Professional | 55 · Aftercare only | $5.62 | $30.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $20.89 Typical High $89.13 | Professional | 56 · Pre-op care only | $3.72 | $20.89 | $89.13 |
Where Alaska sits
The same service costs 4.5 times more in Wisconsin than in Michigan. 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
$209
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.