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 $288.40 Median $5,888.44 Typical High $14,125.38 | Facility | None | $288.40 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $288.40 Typical High $323.59 | Professional | None | $57.54 | $288.40 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $144.54 Typical High $204.17 | Professional | None | $53.70 | $144.54 | $204.17 |
Moda Health Setting Facility Modifier None Typical Low $288.40 Median $323.59 Typical High $467.74 | Facility | None | $288.40 | $323.59 | $467.74 |
Moda Health Setting Professional Modifier None Typical Low $66.07 Median $169.82 Typical High $323.59 | Professional | None | $66.07 | $169.82 | $323.59 |
Premera BCBS Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $234.42 | Professional | None | $208.93 | $208.93 | $234.42 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $346.74 Typical High $489.78 | Facility | None | $288.40 | $346.74 | $489.78 |
Providence Setting Professional Modifier None Typical Low $58.88 Median $128.82 Typical High $169.82 | Professional | None | $58.88 | $128.82 | $169.82 |
United Setting Professional Modifier None Typical Low $81.28 Median $154.88 Typical High $186.21 | Professional | None | $81.28 | $154.88 | $186.21 |
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 $28.84 Median $144.54 Typical High $162.18 | Professional | 52 · Reduced service | $28.84 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $57.54 Typical High $64.57 | Professional | 53 · Discontinued | $11.48 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $218.78 Typical High $245.47 | Professional | 54 · Surgery only | $43.65 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $43.65 Typical High $48.98 | Professional | 55 · Aftercare only | $8.71 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $28.84 Typical High $32.36 | Professional | 56 · Pre-op care only | $5.75 | $28.84 | $32.36 |
Where Alaska sits
The same service costs 3.4 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
$182
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.