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 $9,772.37 Typical High $16,595.87 | Facility | None | $208.93 | $9,772.37 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $208.93 Typical High $891.25 | Professional | None | $45.71 | $208.93 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $186.21 Typical High $630.96 | Professional | None | $47.86 | $186.21 | $630.96 |
Moda Health Setting Facility Modifier None Typical Low $190.55 Median $371.54 Typical High $1,380.38 | Facility | None | $190.55 | $371.54 | $1,380.38 |
Moda Health Setting Professional Modifier None Typical Low $56.23 Median $223.87 Typical High $891.25 | Professional | None | $56.23 | $223.87 | $891.25 |
Premera BCBS Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $851.14 | Professional | None | $173.78 | $173.78 | $851.14 |
Providence Setting Facility Modifier None Typical Low $204.17 Median $295.12 Typical High $1,348.96 | Facility | None | $204.17 | $295.12 | $1,348.96 |
Providence Setting Professional Modifier None Typical Low $61.66 Median $223.87 Typical High $588.84 | Professional | None | $61.66 | $223.87 | $588.84 |
United Setting Professional Modifier None Typical Low $114.82 Median $213.80 Typical High $512.86 | Professional | None | $114.82 | $213.80 | $512.86 |
4 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 $21.88 Median $104.71 Typical High $446.68 | Professional | 52 · Reduced service | $21.88 | $104.71 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $41.69 Typical High $177.83 | Professional | 53 · Discontinued | $8.91 | $41.69 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $31.62 Typical High $134.90 | Professional | 55 · Aftercare only | $6.61 | $31.62 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $20.89 Typical High $89.13 | Professional | 56 · Pre-op care only | $4.47 | $20.89 | $89.13 |
Where Alaska sits
The same service costs 5.2 times more in North Carolina than in Hawaii. 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· 10th of 51
$224
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.