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 $151.36 Median $9,772.37 Typical High $16,595.87 | Facility | None | $151.36 | $9,772.37 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $151.36 Typical High $398.11 | Professional | None | $67.61 | $151.36 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $199.53 Typical High $588.84 | Professional | None | $77.62 | $199.53 | $588.84 |
Moda Health Setting Facility Modifier None Typical Low $151.36 Median $213.80 Typical High $562.34 | Facility | None | $151.36 | $213.80 | $562.34 |
Moda Health Setting Professional Modifier None Typical Low $72.44 Median $213.80 Typical High $602.56 | Professional | None | $72.44 | $213.80 | $602.56 |
Premera BCBS Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Premera BCBS Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $812.83 | Professional | None | $263.03 | $263.03 | $812.83 |
Providence Setting Facility Modifier None Typical Low $112.20 Median $158.49 Typical High $489.78 | Facility | None | $112.20 | $158.49 | $489.78 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $204.17 Typical High $512.86 | Professional | None | $91.20 | $204.17 | $512.86 |
United Setting Professional Modifier None Typical Low $173.78 Median $288.40 Typical High $741.31 | Professional | None | $173.78 | $288.40 | $741.31 |
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 $33.88 Median $75.86 Typical High $199.53 | Professional | 52 · Reduced service | $33.88 | $75.86 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $30.20 Typical High $79.43 | Professional | 53 · Discontinued | $13.80 | $30.20 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $112.20 Typical High $295.12 | Professional | 54 · Surgery only | $51.29 | $112.20 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $22.39 Typical High $58.88 | Professional | 55 · Aftercare only | $10.23 | $22.39 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $15.14 Typical High $39.81 | Professional | 56 · Pre-op care only | $6.92 | $15.14 | $39.81 |
Where Alaska sits
The same service costs 2.9 times more in Washington than in Kentucky. 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· 2nd of 51
$263
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.