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 $5,248.07 Median $5,248.07 Typical High $6,606.93 | Facility | None | $5,248.07 | $5,248.07 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $5,248.07 Typical High $6,606.93 | Professional | None | $1,174.90 | $5,248.07 | $6,606.93 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,819.70 Typical High $5,623.41 | Facility | None | $1,096.48 | $1,819.70 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $2,238.72 Typical High $4,677.35 | Professional | None | $1,071.52 | $2,238.72 | $4,677.35 |
Moda Health Setting Facility Modifier None Typical Low $1,621.81 Median $5,248.07 Typical High $9,549.93 | Facility | None | $1,621.81 | $5,248.07 | $9,549.93 |
Moda Health Setting Professional Modifier None Typical Low $1,380.38 Median $4,897.79 Typical High $7,585.78 | Professional | None | $1,380.38 | $4,897.79 | $7,585.78 |
Premera BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $3,090.30 | Facility | None | $1,513.56 | $1,949.84 | $3,090.30 |
Premera BCBS Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $5,495.41 | Professional | None | $4,168.69 | $4,168.69 | $5,495.41 |
Providence Setting Facility Modifier None Typical Low $1,513.56 Median $3,311.31 Typical High $7,413.10 | Facility | None | $1,513.56 | $3,311.31 | $7,413.10 |
Providence Setting Professional Modifier None Typical Low $1,148.15 Median $2,089.30 Typical High $3,801.89 | Professional | None | $1,148.15 | $2,089.30 | $3,801.89 |
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 $1,548.82 Median $3,715.35 Typical High $7,413.10 | Professional | None | $1,548.82 | $3,715.35 | $7,413.10 |
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 $588.84 Median $2,630.27 Typical High $3,311.31 | Professional | 52 · Reduced service | $588.84 | $2,630.27 | $3,311.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $1,047.13 Typical High $1,348.96 | Professional | 53 · Discontinued | $234.42 | $1,047.13 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $794.33 Typical High $1,000.00 | Professional | 55 · Aftercare only | $173.78 | $794.33 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $524.81 Typical High $660.69 | Professional | 56 · Pre-op care only | $117.49 | $524.81 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $3,715.35 Typical High $4,677.35 | Professional | 78 · Unplanned return to OR | $812.83 | $3,715.35 | $4,677.35 |
Where Alaska sits
The same service costs 5.0 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
$4,169
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.