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 $794.33 Median $3,630.78 Typical High $7,585.78 | Professional | None | $794.33 | $3,630.78 | $7,585.78 |
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 $776.25 Median $1,862.09 Typical High $5,248.07 | Professional | None | $776.25 | $1,862.09 | $5,248.07 |
Moda Health Setting Facility Modifier None Typical Low $1,148.15 Median $3,630.78 Typical High $10,964.78 | Facility | None | $1,148.15 | $3,630.78 | $10,964.78 |
Moda Health Setting Professional Modifier None Typical Low $1,548.82 Median $3,630.78 Typical High $7,943.28 | Professional | None | $1,548.82 | $3,630.78 | $7,943.28 |
Premera BCBS Setting Facility Modifier None Typical Low $3,019.95 Median $5,011.87 Typical High $8,912.51 | Facility | None | $3,019.95 | $5,011.87 | $8,912.51 |
Premera BCBS Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $6,606.93 | Professional | None | $2,951.21 | $2,951.21 | $6,606.93 |
Providence 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 |
Providence Setting Professional Modifier None Typical Low $776.25 Median $1,862.09 Typical High $3,981.07 | Professional | None | $776.25 | $1,862.09 | $3,981.07 |
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 $1,621.81 Median $4,073.80 Typical High $8,511.38 | Professional | None | $1,621.81 | $4,073.80 | $8,511.38 |
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 $398.11 Median $1,819.70 Typical High $3,801.89 | Professional | 52 · Reduced service | $398.11 | $1,819.70 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $741.31 Typical High $1,513.56 | Professional | 53 · Discontinued | $158.49 | $741.31 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $2,754.23 Typical High $5,754.40 | Professional | 54 · Surgery only | $588.84 | $2,754.23 | $5,754.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $549.54 Typical High $1,148.15 | Professional | 55 · Aftercare only | $117.49 | $549.54 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $363.08 Typical High $758.58 | Professional | 56 · Pre-op care only | $79.43 | $363.08 | $758.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $2,570.40 Typical High $5,370.32 | Professional | 78 · Unplanned return to OR | $549.54 | $2,570.40 | $5,370.32 |
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
$4,074
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.