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 $1,318.26 | Professional | None | $114.82 | $588.84 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $316.23 Typical High $741.31 | Professional | None | $151.36 | $316.23 | $741.31 |
Moda Health Setting Facility Modifier None Typical Low $588.84 Median $831.76 Typical High $1,698.24 | Facility | None | $588.84 | $831.76 | $1,698.24 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $588.84 Typical High $1,174.90 | Professional | None | $245.47 | $588.84 | $1,174.90 |
Premera BCBS Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $1,023.29 | Professional | None | $467.74 | $467.74 | $1,023.29 |
Providence Setting Facility Modifier None Typical Low $524.81 Median $1,122.02 Typical High $25,703.96 | Facility | None | $524.81 | $1,122.02 | $25,703.96 |
Providence Setting Professional Modifier None Typical Low $162.18 Median $331.13 Typical High $691.83 | Professional | None | $162.18 | $331.13 | $691.83 |
United Setting Professional Modifier None Typical Low $263.03 Median $501.19 Typical High $1,000.00 | Professional | None | $263.03 | $501.19 | $1,000.00 |
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 $588.84 | Professional | 52 · Reduced service | $57.54 | $295.12 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $117.49 Typical High $234.42 | Professional | 53 · Discontinued | $22.91 | $117.49 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $436.52 Typical High $891.25 | Professional | 54 · Surgery only | $85.11 | $436.52 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $87.10 Typical High $177.83 | Professional | 55 · Aftercare only | $16.98 | $87.10 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $58.88 Typical High $117.49 | Professional | 56 · Pre-op care only | $11.48 | $58.88 | $117.49 |
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
$513
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.