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 $588.84 Median $5,888.44 Typical High $14,125.38 | Facility | None | $588.84 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $588.84 Typical High $1,348.96 | Professional | None | $114.82 | $588.84 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $323.59 Typical High $758.58 | Professional | None | $158.49 | $323.59 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $1,737.80 | Facility | None | $588.84 | $851.14 | $1,737.80 |
Moda Health Setting Professional Modifier None Typical Low $239.88 Median $588.84 Typical High $1,202.26 | Professional | None | $239.88 | $588.84 | $1,202.26 |
Premera BCBS Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $1,047.13 | Professional | None | $478.63 | $478.63 | $1,047.13 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $1,148.15 Typical High $25,703.96 | Facility | None | $537.03 | $1,148.15 | $25,703.96 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $346.74 Typical High $724.44 | Professional | None | $165.96 | $346.74 | $724.44 |
United Setting Professional Modifier None Typical Low $269.15 Median $512.86 Typical High $1,023.29 | Professional | None | $269.15 | $512.86 | $1,023.29 |
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 $57.54 Median $295.12 Typical High $602.56 | Professional | 52 · Reduced service | $57.54 | $295.12 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $120.23 Typical High $239.88 | Professional | 53 · Discontinued | $22.91 | $120.23 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $446.68 Typical High $912.01 | Professional | 54 · Surgery only | $87.10 | $446.68 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $89.13 Typical High $181.97 | Professional | 55 · Aftercare only | $17.38 | $89.13 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $58.88 Typical High $120.23 | Professional | 56 · Pre-op care only | $11.48 | $58.88 | $120.23 |
Where Alaska sits
The same service costs 3.4 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
$525
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.