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 $707.95 Median $7,079.46 Typical High $14,125.38 | Facility | None | $707.95 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $407.38 Typical High $1,023.29 | Professional | None | $151.36 | $407.38 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $407.38 Typical High $1,258.93 | Facility | None | $245.47 | $407.38 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $302.00 Typical High $660.69 | Professional | None | $154.88 | $302.00 | $660.69 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $707.95 Typical High $1,445.44 | Facility | None | $165.96 | $707.95 | $1,445.44 |
Moda Health Setting Professional Modifier None Typical Low $154.88 Median $575.44 Typical High $1,071.52 | Professional | None | $154.88 | $575.44 | $1,071.52 |
Premera BCBS Setting Facility Modifier None Typical Low $269.15 Median $398.11 Typical High $549.54 | Facility | None | $269.15 | $398.11 | $549.54 |
Premera BCBS Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $891.25 | Professional | None | $602.56 | $602.56 | $891.25 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $741.31 Typical High $1,621.81 | Facility | None | $338.84 | $741.31 | $1,621.81 |
Providence Setting Professional Modifier None Typical Low $141.25 Median $302.00 Typical High $512.86 | Professional | None | $141.25 | $302.00 | $512.86 |
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 $199.53 Median $524.81 Typical High $1,071.52 | Professional | None | $199.53 | $524.81 | $1,071.52 |
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 $75.86 Median $354.81 Typical High $512.86 | Professional | 52 · Reduced service | $75.86 | $354.81 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $141.25 Typical High $204.17 | Professional | 53 · Discontinued | $30.20 | $141.25 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $537.03 Typical High $758.58 | Professional | 54 · Surgery only | $112.20 | $537.03 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $107.15 Typical High $151.36 | Professional | 55 · Aftercare only | $22.39 | $107.15 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $70.79 Typical High $102.33 | Professional | 56 · Pre-op care only | $15.14 | $70.79 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $501.19 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $104.71 | $501.19 | $707.95 |
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
$603
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.