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 $537.03 Median $5,888.44 Typical High $14,125.38 | Facility | None | $537.03 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $288.40 Typical High $724.44 | Professional | None | $120.23 | $288.40 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $245.47 Typical High $758.58 | Facility | None | $147.91 | $245.47 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $218.78 Typical High $489.78 | Professional | None | $114.82 | $218.78 | $489.78 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $537.03 Typical High $1,047.13 | Facility | None | $173.78 | $537.03 | $1,047.13 |
Moda Health Setting Professional Modifier None Typical Low $125.89 Median $426.58 Typical High $741.31 | Professional | None | $125.89 | $426.58 | $741.31 |
Premera BCBS Setting Facility Modifier None Typical Low $151.36 Median $218.78 Typical High $263.03 | Facility | None | $151.36 | $218.78 | $263.03 |
Premera BCBS Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $660.69 | Professional | None | $467.74 | $467.74 | $660.69 |
Providence Setting Facility Modifier None Typical Low $204.17 Median $446.68 Typical High $776.25 | Facility | None | $204.17 | $446.68 | $776.25 |
Providence Setting Professional Modifier None Typical Low $112.20 Median $239.88 Typical High $380.19 | Professional | None | $112.20 | $239.88 | $380.19 |
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 $147.91 Median $389.05 Typical High $776.25 | Professional | None | $147.91 | $389.05 | $776.25 |
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 $269.15 Typical High $363.08 | Professional | 52 · Reduced service | $60.26 | $269.15 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $109.65 Typical High $144.54 | Professional | 53 · Discontinued | $23.99 | $109.65 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $407.38 Typical High $549.54 | Professional | 54 · Surgery only | $89.13 | $407.38 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $81.28 Typical High $109.65 | Professional | 55 · Aftercare only | $18.20 | $81.28 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $53.70 Typical High $72.44 | Professional | 56 · Pre-op care only | $12.02 | $53.70 | $72.44 |
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
$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.