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 $1,949.84 Median $7,079.46 Typical High $14,125.38 | Facility | None | $1,949.84 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $3,311.31 Typical High $3,890.45 | Professional | None | $707.95 | $3,311.31 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $7,762.47 Typical High $23,988.33 | Facility | None | $4,677.35 | $7,762.47 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,318.26 Typical High $2,691.53 | Professional | None | $691.83 | $1,318.26 | $2,691.53 |
Moda Health Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $5,495.41 | Facility | None | $1,047.13 | $3,311.31 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $776.25 Median $2,884.03 Typical High $4,570.88 | Professional | None | $776.25 | $2,884.03 | $4,570.88 |
Premera BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $6,456.54 Typical High $8,709.64 | Facility | None | $4,570.88 | $6,456.54 | $8,709.64 |
Premera BCBS Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,235.94 | Professional | None | $2,691.53 | $2,691.53 | $3,235.94 |
Providence Setting Facility Modifier None Typical Low $4,265.80 Median $6,456.54 Typical High $16,218.10 | Facility | None | $4,265.80 | $6,456.54 | $16,218.10 |
Providence Setting Professional Modifier None Typical Low $707.95 Median $1,348.96 Typical High $2,290.87 | Professional | None | $707.95 | $1,348.96 | $2,290.87 |
United Setting Facility Modifier None Typical Low $3,388.44 Median $7,585.78 Typical High $19,498.45 | Facility | None | $3,388.44 | $7,585.78 | $19,498.45 |
United Setting Professional Modifier None Typical Low $977.24 Median $2,137.96 Typical High $4,265.80 | Professional | None | $977.24 | $2,137.96 | $4,265.80 |
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 $354.81 Median $1,659.59 Typical High $1,905.46 | Professional | 52 · Reduced service | $354.81 | $1,659.59 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $660.69 Typical High $776.25 | Professional | 53 · Discontinued | $141.25 | $660.69 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $2,454.71 Typical High $2,884.03 | Professional | 54 · Surgery only | $524.81 | $2,454.71 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $489.78 Typical High $575.44 | Professional | 55 · Aftercare only | $107.15 | $489.78 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $331.13 Typical High $389.05 | Professional | 56 · Pre-op care only | $70.79 | $331.13 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $2,290.87 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $489.78 | $2,290.87 | $2,691.53 |
Where Alaska sits
The same service costs 5.8 times more in Alaska than in Utah. 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
$3,236
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.