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 $281.84 Median $5,888.44 Typical High $14,125.38 | Facility | None | $281.84 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $158.49 Typical High $407.38 | Professional | None | $67.61 | $158.49 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $128.82 Typical High $398.11 | Facility | None | $77.62 | $128.82 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $147.91 Typical High $275.42 | Professional | None | $56.23 | $147.91 | $275.42 |
Moda Health Setting Facility Modifier None Typical Low $87.10 Median $281.84 Typical High $588.84 | Facility | None | $87.10 | $281.84 | $588.84 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $234.42 Typical High $407.38 | Professional | None | $74.13 | $234.42 | $407.38 |
Premera BCBS Setting Facility Modifier None Typical Low $97.72 Median $144.54 Typical High $302.00 | Facility | None | $97.72 | $144.54 | $302.00 |
Premera BCBS Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $346.74 | Professional | None | $223.87 | $223.87 | $346.74 |
Providence Setting Facility Modifier None Typical Low $107.15 Median $234.42 Typical High $602.56 | Facility | None | $107.15 | $234.42 | $602.56 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $128.82 Typical High $218.78 | Professional | None | $60.26 | $128.82 | $218.78 |
United Setting Facility Modifier None Typical Low $831.76 Median $1,778.28 Typical High $2,951.21 | Facility | None | $831.76 | $1,778.28 | $2,951.21 |
United Setting Professional Modifier None Typical Low $91.20 Median $223.87 Typical High $501.19 | Professional | None | $91.20 | $223.87 | $501.19 |
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 $36.31 Median $138.04 Typical High $204.17 | Professional | 52 · Reduced service | $36.31 | $138.04 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $56.23 Typical High $83.18 | Professional | 53 · Discontinued | $14.45 | $56.23 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $208.93 Typical High $309.03 | Professional | 54 · Surgery only | $53.70 | $208.93 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $41.69 Typical High $61.66 | Professional | 55 · Aftercare only | $10.72 | $41.69 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $28.18 Typical High $40.74 | Professional | 56 · Pre-op care only | $7.24 | $28.18 | $40.74 |
Where Alaska sits
The same service costs 3.2 times more in Alaska than in Kentucky. 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
$224
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.