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 $9,772.37 Typical High $16,595.87 | Facility | None | $2,344.23 | $9,772.37 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $3,019.95 Typical High $3,890.45 | Professional | None | $645.65 | $3,019.95 | $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 $645.65 Median $1,258.93 Typical High $2,570.40 | Professional | None | $645.65 | $1,258.93 | $2,570.40 |
Moda Health Setting Facility Modifier None Typical Low $933.25 Median $3,019.95 Typical High $5,495.41 | Facility | None | $933.25 | $3,019.95 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $758.58 Median $2,570.40 Typical High $3,890.45 | Professional | None | $758.58 | $2,570.40 | $3,890.45 |
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 $2,454.71 Median $2,454.71 Typical High $3,235.94 | Professional | None | $2,454.71 | $2,454.71 | $3,235.94 |
Providence Setting Facility Modifier None Typical Low $3,981.07 Median $6,456.54 Typical High $23,988.33 | Facility | None | $3,981.07 | $6,456.54 | $23,988.33 |
Providence Setting Professional Modifier None Typical Low $645.65 Median $1,288.25 Typical High $1,995.26 | Professional | None | $645.65 | $1,288.25 | $1,995.26 |
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 $794.33 Median $2,041.74 Typical High $4,073.80 | Professional | None | $794.33 | $2,041.74 | $4,073.80 |
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 $309.03 Median $1,513.56 Typical High $1,949.84 | Professional | 52 · Reduced service | $309.03 | $1,513.56 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $602.56 Typical High $776.25 | Professional | 53 · Discontinued | $123.03 | $602.56 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $2,238.72 Typical High $2,884.03 | Professional | 54 · Surgery only | $467.74 | $2,238.72 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $457.09 Typical High $588.84 | Professional | 55 · Aftercare only | $93.33 | $457.09 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $302.00 Typical High $389.05 | Professional | 56 · Pre-op care only | $61.66 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $2,089.30 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $436.52 | $2,089.30 | $2,691.53 |
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
$3,020
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.