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 $1,230.27 Median $5,888.44 Typical High $14,125.38 | Facility | None | $1,230.27 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $524.81 Typical High $1,737.80 | Professional | None | $263.03 | $524.81 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $724.44 Typical High $2,238.72 | Facility | None | $436.52 | $724.44 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $537.03 Typical High $1,122.02 | Professional | None | $269.15 | $537.03 | $1,122.02 |
Moda Health Setting Facility Modifier None Typical Low $407.38 Median $1,737.80 Typical High $4,786.30 | Facility | None | $407.38 | $1,737.80 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $275.42 Median $977.24 Typical High $1,819.70 | Professional | None | $275.42 | $977.24 | $1,819.70 |
Premera BCBS Setting Facility Modifier None Typical Low $467.74 Median $707.95 Typical High $977.24 | Facility | None | $467.74 | $707.95 | $977.24 |
Premera BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,513.56 | Professional | None | $1,071.52 | $1,071.52 | $1,513.56 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,258.93 Typical High $2,238.72 | Facility | None | $602.56 | $1,258.93 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $245.47 Median $537.03 Typical High $870.96 | Professional | None | $245.47 | $537.03 | $870.96 |
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 $354.81 Median $891.25 Typical High $1,819.70 | Professional | None | $354.81 | $891.25 | $1,819.70 |
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 $134.90 Median $616.60 Typical High $870.96 | Professional | 52 · Reduced service | $134.90 | $616.60 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $251.19 Typical High $346.74 | Professional | 53 · Discontinued | $53.70 | $251.19 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $933.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $199.53 | $933.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $186.21 Typical High $263.03 | Professional | 55 · Aftercare only | $39.81 | $186.21 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $123.03 Typical High $173.78 | Professional | 56 · Pre-op care only | $26.92 | $123.03 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $870.96 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $186.21 | $870.96 | $1,230.27 |
Where Alaska sits
The same service costs 4.5 times more in Alaska than in Texas. 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
$1,072
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.