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 $436.52 Median $5,888.44 Typical High $14,125.38 | Facility | None | $436.52 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $436.52 Typical High $575.44 | Professional | None | $89.13 | $436.52 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $204.17 Typical High $309.03 | Professional | None | $83.18 | $204.17 | $309.03 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $575.44 Typical High $812.83 | Facility | None | $436.52 | $575.44 | $812.83 |
Moda Health Setting Professional Modifier None Typical Low $109.65 Median $309.03 Typical High $575.44 | Professional | None | $109.65 | $309.03 | $575.44 |
Premera BCBS Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $436.52 | Professional | None | $323.59 | $323.59 | $436.52 |
Providence Setting Facility Modifier None Typical Low $407.38 Median $575.44 Typical High $831.76 | Facility | None | $407.38 | $575.44 | $831.76 |
Providence Setting Professional Modifier None Typical Low $93.33 Median $199.53 Typical High $281.84 | Professional | None | $93.33 | $199.53 | $281.84 |
United Setting Professional Modifier None Typical Low $117.49 Median $223.87 Typical High $288.40 | Professional | None | $117.49 | $223.87 | $288.40 |
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 $44.67 Median $218.78 Typical High $281.84 | Professional | 52 · Reduced service | $44.67 | $218.78 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $87.10 Typical High $114.82 | Professional | 53 · Discontinued | $17.78 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $331.13 Typical High $426.58 | Professional | 54 · Surgery only | $66.07 | $331.13 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $66.07 Typical High $85.11 | Professional | 55 · Aftercare only | $13.49 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $43.65 Typical High $57.54 | Professional | 56 · Pre-op care only | $8.91 | $43.65 | $57.54 |
Where Alaska sits
The same service costs 3.8 times more in Alaska than in Florida. 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
$324
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.