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 $794.33 Median $5,888.44 Typical High $14,125.38 | Facility | None | $794.33 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $794.33 Typical High $1,621.81 | Professional | None | $151.36 | $794.33 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $478.63 Typical High $1,000.00 | Professional | None | $190.55 | $478.63 | $1,000.00 |
Moda Health Setting Facility Modifier None Typical Low $794.33 Median $1,122.02 Typical High $2,290.87 | Facility | None | $794.33 | $1,122.02 | $2,290.87 |
Moda Health Setting Professional Modifier None Typical Low $223.87 Median $794.33 Typical High $1,621.81 | Professional | None | $223.87 | $794.33 | $1,621.81 |
Premera BCBS Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $1,380.38 | Professional | None | $630.96 | $630.96 | $1,380.38 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $1,047.13 Typical High $2,398.83 | Facility | None | $741.31 | $1,047.13 | $2,398.83 |
Providence Setting Professional Modifier None Typical Low $229.09 Median $478.63 Typical High $977.24 | Professional | None | $229.09 | $478.63 | $977.24 |
United Setting Professional Modifier None Typical Low $363.08 Median $691.83 Typical High $1,380.38 | Professional | None | $363.08 | $691.83 | $1,380.38 |
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 $75.86 Median $389.05 Typical High $794.33 | Professional | 52 · Reduced service | $75.86 | $389.05 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $158.49 Typical High $323.59 | Professional | 53 · Discontinued | $30.20 | $158.49 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $588.84 Typical High $1,202.26 | Professional | 54 · Surgery only | $114.82 | $588.84 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $117.49 Typical High $239.88 | Professional | 55 · Aftercare only | $22.91 | $117.49 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $79.43 Typical High $162.18 | Professional | 56 · Pre-op care only | $15.14 | $79.43 | $162.18 |
Where Alaska sits
The same service costs 3.3 times more in Alaska than in Virginia. 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
$676
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.