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 $549.54 Median $5,888.44 Typical High $14,125.38 | Facility | None | $549.54 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $223.87 Typical High $812.83 | Professional | None | $114.82 | $223.87 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $302.00 Typical High $933.25 | Facility | None | $181.97 | $302.00 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $229.09 Typical High $537.03 | Professional | None | $114.82 | $229.09 | $537.03 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $549.54 Typical High $1,148.15 | Facility | None | $173.78 | $549.54 | $1,148.15 |
Moda Health Setting Professional Modifier None Typical Low $117.49 Median $478.63 Typical High $831.76 | Professional | None | $117.49 | $478.63 | $831.76 |
Premera BCBS Setting Facility Modifier None Typical Low $186.21 Median $269.15 Typical High $309.03 | Facility | None | $186.21 | $269.15 | $309.03 |
Premera BCBS Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $724.44 | Professional | None | $467.74 | $467.74 | $724.44 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $501.19 Typical High $933.25 | Facility | None | $251.19 | $501.19 | $933.25 |
Providence Setting Professional Modifier None Typical Low $114.82 Median $239.88 Typical High $416.87 | Professional | None | $114.82 | $239.88 | $416.87 |
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 $165.96 Median $436.52 Typical High $870.96 | Professional | None | $165.96 | $436.52 | $870.96 |
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 $60.26 Median $275.42 Typical High $398.11 | Professional | 52 · Reduced service | $60.26 | $275.42 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $109.65 Typical High $162.18 | Professional | 53 · Discontinued | $23.99 | $109.65 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $407.38 Typical High $602.56 | Professional | 54 · Surgery only | $91.20 | $407.38 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $83.18 Typical High $120.23 | Professional | 55 · Aftercare only | $18.20 | $83.18 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $54.95 Typical High $81.28 | Professional | 56 · Pre-op care only | $12.02 | $54.95 | $81.28 |
Where Alaska sits
The same service costs 3.3 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
$468
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.