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 $436.52 Median $5,888.44 Typical High $14,125.38 | Facility | None | $436.52 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $436.52 Typical High $4,677.35 | Professional | None | $91.20 | $436.52 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $208.93 Typical High $645.65 | Facility | None | $125.89 | $208.93 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $162.18 Typical High $363.08 | Professional | None | $93.33 | $162.18 | $363.08 |
Moda Health Setting Facility Modifier None Typical Low $141.25 Median $436.52 Typical High $851.14 | Facility | None | $141.25 | $436.52 | $851.14 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $416.87 Typical High $691.83 | Professional | None | $102.33 | $416.87 | $691.83 |
Premera BCBS Setting Facility Modifier None Typical Low $169.82 Median $190.55 Typical High $1,445.44 | Facility | None | $169.82 | $190.55 | $1,445.44 |
Premera BCBS Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Providence Setting Facility Modifier None Typical Low $173.78 Median $380.19 Typical High $645.65 | Facility | None | $173.78 | $380.19 | $645.65 |
Providence Setting Professional Modifier None Typical Low $81.28 Median $181.97 Typical High $288.40 | Professional | None | $81.28 | $181.97 | $288.40 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $3,162.28 Typical High $4,265.80 | Facility | None | $1,096.48 | $3,162.28 | $4,265.80 |
United Setting Professional Modifier None Typical Low $125.89 Median $295.12 Typical High $588.84 | Professional | None | $125.89 | $295.12 | $588.84 |
6 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 $45.71 Median $218.78 Typical High $295.12 | Professional | 52 · Reduced service | $45.71 | $218.78 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $87.10 Typical High $117.49 | Professional | 53 · Discontinued | $18.20 | $87.10 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $331.13 Typical High $446.68 | Professional | 54 · Surgery only | $69.18 | $331.13 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $66.07 Typical High $89.13 | Professional | 55 · Aftercare only | $13.80 | $66.07 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $43.65 Typical High $58.88 | Professional | 56 · Pre-op care only | $9.12 | $43.65 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $309.03 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $64.57 | $309.03 | $416.87 |
Where Alaska sits
The same service costs 4.0 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
$363
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.