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 $2,344.23 Median $12,022.64 Typical High $20,892.96 | Facility | None | $2,344.23 | $12,022.64 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $2,630.27 Typical High $3,090.30 | Professional | None | $588.84 | $2,630.27 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $5,495.41 Typical High $16,982.44 | Facility | None | $3,311.31 | $5,495.41 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $1,122.02 Typical High $2,187.76 | Professional | None | $549.54 | $1,122.02 | $2,187.76 |
Moda Health Setting Facility Modifier None Typical Low $831.76 Median $2,630.27 Typical High $4,365.16 | Facility | None | $831.76 | $2,630.27 | $4,365.16 |
Moda Health Setting Professional Modifier None Typical Low $616.60 Median $2,290.87 Typical High $3,467.37 | Professional | None | $616.60 | $2,290.87 | $3,467.37 |
Premera BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $3,090.30 Typical High $4,786.30 | Facility | None | $2,041.74 | $3,090.30 | $4,786.30 |
Premera BCBS Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,570.40 | Professional | None | $2,137.96 | $2,137.96 | $2,570.40 |
Providence Setting Facility Modifier None Typical Low $3,311.31 Median $4,786.30 Typical High $16,982.44 | Facility | None | $3,311.31 | $4,786.30 | $16,982.44 |
Providence Setting Professional Modifier None Typical Low $588.84 Median $1,096.48 Typical High $1,905.46 | Professional | None | $588.84 | $1,096.48 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $6,165.95 Typical High $8,912.51 | Facility | None | $1,905.46 | $6,165.95 | $8,912.51 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,778.28 Typical High $3,630.78 | Professional | None | $758.58 | $1,778.28 | $3,630.78 |
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 $309.03 Median $1,318.26 Typical High $1,548.82 | Professional | 52 · Reduced service | $309.03 | $1,318.26 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $524.81 Typical High $616.60 | Professional | 53 · Discontinued | $123.03 | $524.81 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $1,995.26 Typical High $2,290.87 | Professional | 54 · Surgery only | $457.09 | $1,995.26 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $398.11 Typical High $457.09 | Professional | 55 · Aftercare only | $91.20 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $263.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $61.66 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $1,862.09 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $426.58 | $1,862.09 | $2,137.96 |
Where Alaska sits
The same service costs 6.2 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
$2,570
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.