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 $1,621.81 Median $10,715.19 Typical High $14,125.38 | Facility | None | $1,621.81 | $10,715.19 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $1,621.81 Typical High $10,715.19 | Professional | None | $338.84 | $1,621.81 | $10,715.19 |
Cigna Setting Facility Modifier None Typical Low $2,290.87 Median $3,801.89 Typical High $11,748.98 | Facility | None | $2,290.87 | $3,801.89 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $660.69 Typical High $1,380.38 | Professional | None | $346.74 | $660.69 | $1,380.38 |
Moda Health Setting Facility Modifier None Typical Low $489.78 Median $1,621.81 Typical High $3,019.95 | Facility | None | $489.78 | $1,621.81 | $3,019.95 |
Moda Health Setting Professional Modifier None Typical Low $416.87 Median $1,479.11 Typical High $2,344.23 | Professional | None | $416.87 | $1,479.11 | $2,344.23 |
Premera BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $3,162.28 Typical High $6,165.95 | Facility | None | $2,041.74 | $3,162.28 | $6,165.95 |
Premera BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,819.70 | Professional | None | $1,348.96 | $1,348.96 | $1,819.70 |
Providence Setting Facility Modifier None Typical Low $2,187.76 Median $3,162.28 Typical High $11,748.98 | Facility | None | $2,187.76 | $3,162.28 | $11,748.98 |
Providence Setting Professional Modifier None Typical Low $302.00 Median $676.08 Typical High $1,047.13 | Professional | None | $302.00 | $676.08 | $1,047.13 |
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 $407.38 Median $1,096.48 Typical High $2,187.76 | Professional | None | $407.38 | $1,096.48 | $2,187.76 |
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 $169.82 Median $812.83 Typical High $1,071.52 | Professional | 52 · Reduced service | $169.82 | $812.83 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $323.59 Typical High $426.58 | Professional | 53 · Discontinued | $67.61 | $323.59 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $1,202.26 Typical High $1,584.89 | Professional | 54 · Surgery only | $251.19 | $1,202.26 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $239.88 Typical High $316.23 | Professional | 55 · Aftercare only | $50.12 | $239.88 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $162.18 Typical High $213.80 | Professional | 56 · Pre-op care only | $33.88 | $162.18 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $1,122.02 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $234.42 | $1,122.02 | $1,479.11 |
Where Alaska sits
The same service costs 5.0 times more in Alaska than in Utah. 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
$1,622
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.