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 $123.03 Median $7,079.46 Typical High $14,125.38 | Facility | None | $123.03 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $123.03 Typical High $169.82 | Professional | None | $24.55 | $123.03 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $41.69 Typical High $125.89 | Facility | None | $25.12 | $41.69 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $60.26 Typical High $107.15 | Professional | None | $24.55 | $60.26 | $107.15 |
Moda Health Setting Facility Modifier None Typical Low $38.90 Median $123.03 Typical High $218.78 | Facility | None | $38.90 | $123.03 | $218.78 |
Moda Health Setting Professional Modifier None Typical Low $25.70 Median $89.13 Typical High $154.88 | Professional | None | $25.70 | $89.13 | $154.88 |
Premera BCBS Setting Facility Modifier None Typical Low $31.62 Median $41.69 Typical High $91.20 | Facility | None | $31.62 | $41.69 | $91.20 |
Premera BCBS Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $128.82 | Professional | None | $100.00 | $100.00 | $128.82 |
Providence Setting Facility Modifier None Typical Low $34.67 Median $74.13 Typical High $229.09 | Facility | None | $34.67 | $74.13 | $229.09 |
Providence Setting Professional Modifier None Typical Low $33.88 Median $60.26 Typical High $87.10 | Professional | None | $33.88 | $60.26 | $87.10 |
United Setting Facility Modifier None Typical Low $478.63 Median $954.99 Typical High $1,174.90 | Facility | None | $478.63 | $954.99 | $1,174.90 |
United Setting Professional Modifier None Typical Low $30.90 Median $85.11 Typical High $169.82 | Professional | None | $30.90 | $85.11 | $169.82 |
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 $12.88 Median $61.66 Typical High $75.86 | Professional | 52 · Reduced service | $12.88 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $24.55 Typical High $30.90 | Professional | 53 · Discontinued | $5.13 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $91.20 Typical High $114.82 | Professional | 54 · Surgery only | $19.50 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $18.20 Typical High $22.91 | Professional | 55 · Aftercare only | $3.89 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $12.30 Typical High $15.49 | Professional | 56 · Pre-op care only | $2.57 | $12.30 | $15.49 |
Where Alaska sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$100
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.