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 $1,737.80 Median $7,079.46 Typical High $14,125.38 | Facility | None | $1,737.80 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $1,737.80 Typical High $7,079.46 | Professional | None | $467.74 | $1,737.80 | $7,079.46 |
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 $371.54 Median $870.96 Typical High $2,041.74 | Professional | None | $371.54 | $870.96 | $2,041.74 |
Moda Health Setting Facility Modifier None Typical Low $562.34 Median $1,737.80 Typical High $4,168.69 | Facility | None | $562.34 | $1,737.80 | $4,168.69 |
Moda Health Setting Professional Modifier None Typical Low $575.44 Median $1,737.80 Typical High $3,311.31 | Professional | None | $575.44 | $1,737.80 | $3,311.31 |
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 $1,445.44 Median $1,445.44 Typical High $2,511.89 | Professional | None | $1,445.44 | $1,445.44 | $2,511.89 |
Providence Setting Facility Modifier None Typical Low $2,511.89 Median $6,456.54 Typical High $16,218.10 | Facility | None | $2,511.89 | $6,456.54 | $16,218.10 |
Providence Setting Professional Modifier None Typical Low $380.19 Median $870.96 Typical High $1,513.56 | Professional | None | $380.19 | $870.96 | $1,513.56 |
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 $630.96 Median $1,659.59 Typical High $3,311.31 | Professional | None | $630.96 | $1,659.59 | $3,311.31 |
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 $229.09 Median $870.96 Typical High $1,445.44 | Professional | 52 · Reduced service | $229.09 | $870.96 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $346.74 Typical High $575.44 | Professional | 53 · Discontinued | $93.33 | $346.74 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $1,288.25 Typical High $2,187.76 | Professional | 54 · Surgery only | $346.74 | $1,288.25 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $263.03 Typical High $436.52 | Professional | 55 · Aftercare only | $69.18 | $263.03 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $173.78 Typical High $288.40 | Professional | 56 · Pre-op care only | $46.77 | $173.78 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $1,202.26 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $323.59 | $1,202.26 | $2,041.74 |
Where Alaska sits
The same service costs 4.9 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
$1,862
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.