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 $269.15 Median $5,888.44 Typical High $14,125.38 | Facility | None | $269.15 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $154.88 Typical High $512.86 | Professional | None | $79.43 | $154.88 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $218.78 Typical High $676.08 | Facility | None | $131.83 | $218.78 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $141.25 Typical High $354.81 | Professional | None | $54.95 | $141.25 | $354.81 |
Moda Health Setting Facility Modifier None Typical Low $89.13 Median $389.05 Typical High $2,089.30 | Facility | None | $89.13 | $389.05 | $2,089.30 |
Moda Health Setting Professional Modifier None Typical Low $91.20 Median $269.15 Typical High $562.34 | Professional | None | $91.20 | $269.15 | $562.34 |
Premera BCBS Setting Facility Modifier None Typical Low $134.90 Median $208.93 Typical High $302.00 | Facility | None | $134.90 | $208.93 | $302.00 |
Premera BCBS Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $446.68 | Professional | None | $218.78 | $218.78 | $446.68 |
Providence Setting Facility Modifier None Typical Low $181.97 Median $281.84 Typical High $776.25 | Facility | None | $181.97 | $281.84 | $776.25 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $269.15 | Professional | None | $91.20 | $141.25 | $269.15 |
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 $117.49 Median $281.84 Typical High $562.34 | Professional | None | $117.49 | $281.84 | $562.34 |
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 $42.66 Median $134.90 Typical High $251.19 | Professional | 52 · Reduced service | $42.66 | $134.90 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $53.70 Typical High $102.33 | Professional | 53 · Discontinued | $16.98 | $53.70 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $204.17 Typical High $380.19 | Professional | 54 · Surgery only | $64.57 | $204.17 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $40.74 Typical High $75.86 | Professional | 55 · Aftercare only | $12.88 | $40.74 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $26.92 Typical High $51.29 | Professional | 56 · Pre-op care only | $8.51 | $26.92 | $51.29 |
Where Alaska sits
The same service costs 3.2 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
$263
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.