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 $204.17 Median $5,888.44 Typical High $14,125.38 | Facility | None | $204.17 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $204.17 Typical High $416.87 | Professional | None | $61.66 | $204.17 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $138.04 Typical High $426.58 | Facility | None | $83.18 | $138.04 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $107.15 Typical High $239.88 | Professional | None | $41.69 | $107.15 | $239.88 |
Moda Health Setting Facility Modifier None Typical Low $128.82 Median $575.44 Typical High $2,290.87 | Facility | None | $128.82 | $575.44 | $2,290.87 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $204.17 Typical High $478.63 | Professional | None | $69.18 | $204.17 | $478.63 |
Premera BCBS Setting Facility Modifier None Typical Low $102.33 Median $147.91 Typical High $204.17 | Facility | None | $102.33 | $147.91 | $204.17 |
Premera BCBS Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $302.00 | Professional | None | $169.82 | $302.00 | $302.00 |
Providence Setting Facility Modifier None Typical Low $114.82 Median $194.98 Typical High $524.81 | Facility | None | $114.82 | $194.98 | $524.81 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $104.71 Typical High $186.21 | Professional | None | $60.26 | $104.71 | $186.21 |
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 $194.98 Typical High $389.05 | Professional | None | $91.20 | $194.98 | $389.05 |
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 $26.30 Median $102.33 Typical High $173.78 | Professional | 52 · Reduced service | $26.30 | $102.33 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $41.69 Typical High $69.18 | Professional | 53 · Discontinued | $10.47 | $41.69 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $154.88 Typical High $257.04 | Professional | 54 · Surgery only | $39.81 | $154.88 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $30.90 Typical High $52.48 | Professional | 55 · Aftercare only | $7.94 | $30.90 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $20.42 Typical High $34.67 | Professional | 56 · Pre-op care only | $5.25 | $20.42 | $34.67 |
Where Alaska sits
The same service costs 3.5 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
$204
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.