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 $389.05 Median $5,888.44 Typical High $14,125.38 | Facility | None | $389.05 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $218.78 Typical High $549.54 | Professional | None | $83.18 | $218.78 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $162.18 Typical High $371.54 | Professional | None | $81.28 | $162.18 | $371.54 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $389.05 Typical High $794.33 | Facility | None | $120.23 | $389.05 | $794.33 |
Moda Health Setting Professional Modifier None Typical Low $87.10 Median $323.59 Typical High $575.44 | Professional | None | $87.10 | $323.59 | $575.44 |
Premera BCBS Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $489.78 | Professional | None | $331.13 | $331.13 | $489.78 |
Providence Setting Facility Modifier None Typical Low $346.74 Median $489.78 Typical High $851.14 | Facility | None | $346.74 | $489.78 | $851.14 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $165.96 Typical High $288.40 | Professional | None | $79.43 | $165.96 | $288.40 |
United Setting Facility Modifier None Typical Low $478.63 Median $954.99 Typical High $1,174.90 | Facility | None | $478.63 | $954.99 | $1,174.90 |
United Setting Professional Modifier None Typical Low $112.20 Median $302.00 Typical High $602.56 | Professional | None | $112.20 | $302.00 | $602.56 |
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 $41.69 Median $194.98 Typical High $275.42 | Professional | 52 · Reduced service | $41.69 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $77.62 Typical High $109.65 | Professional | 53 · Discontinued | $16.60 | $77.62 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $288.40 Typical High $416.87 | Professional | 54 · Surgery only | $63.10 | $288.40 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $58.88 Typical High $83.18 | Professional | 55 · Aftercare only | $12.59 | $58.88 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $38.90 Typical High $54.95 | Professional | 56 · Pre-op care only | $8.32 | $38.90 | $54.95 |
Where Alaska sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$331
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.