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 $208.93 Median $5,888.44 Typical High $14,125.38 | Facility | None | $208.93 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $208.93 Typical High $371.54 | Professional | None | $58.88 | $208.93 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $120.23 Typical High $363.08 | Facility | None | $72.44 | $120.23 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $125.89 Typical High $234.42 | Professional | None | $43.65 | $125.89 | $234.42 |
Moda Health Setting Facility Modifier None Typical Low $67.61 Median $208.93 Typical High $524.81 | Facility | None | $67.61 | $208.93 | $524.81 |
Moda Health Setting Professional Modifier None Typical Low $77.62 Median $190.55 Typical High $371.54 | Professional | None | $77.62 | $190.55 | $371.54 |
Premera BCBS Setting Facility Modifier None Typical Low $109.65 Median $154.88 Typical High $354.81 | Facility | None | $109.65 | $154.88 | $354.81 |
Premera BCBS Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $323.59 | Professional | None | $177.83 | $177.83 | $323.59 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $190.55 Typical High $489.78 | Facility | None | $100.00 | $190.55 | $489.78 |
Providence Setting Professional Modifier None Typical Low $77.62 Median $131.83 Typical High $190.55 | Professional | None | $77.62 | $131.83 | $190.55 |
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 $109.65 Median $186.21 Typical High $371.54 | Professional | None | $109.65 | $186.21 | $371.54 |
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 $37.15 Median $104.71 Typical High $186.21 | Professional | 52 · Reduced service | $37.15 | $104.71 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $42.66 Typical High $74.13 | Professional | 53 · Discontinued | $14.79 | $42.66 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $158.49 Typical High $275.42 | Professional | 54 · Surgery only | $56.23 | $158.49 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $31.62 Typical High $54.95 | Professional | 55 · Aftercare only | $11.22 | $31.62 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $20.89 Typical High $37.15 | Professional | 56 · Pre-op care only | $7.41 | $20.89 | $37.15 |
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
$191
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.