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 $630.96 Median $3,019.95 Typical High $3,715.35 | Professional | None | $630.96 | $3,019.95 | $3,715.35 |
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 $660.69 Median $1,148.15 Typical High $2,454.71 | Professional | None | $660.69 | $1,148.15 | $2,454.71 |
Moda Health Setting Facility Modifier None Typical Low $912.01 Median $3,019.95 Typical High $5,248.07 | Facility | None | $912.01 | $3,019.95 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $741.31 Median $2,630.27 Typical High $3,981.07 | Professional | None | $741.31 | $2,630.27 | $3,981.07 |
Premera BCBS Setting Facility Modifier None Typical Low $3,090.30 Median $6,456.54 Typical High $8,912.51 | Facility | None | $3,090.30 | $6,456.54 | $8,912.51 |
Premera BCBS Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $3,162.28 | Professional | None | $2,570.40 | $2,570.40 | $3,162.28 |
Providence Setting Facility Modifier None Typical Low $3,715.35 Median $6,456.54 Typical High $23,988.33 | Facility | None | $3,715.35 | $6,456.54 | $23,988.33 |
Providence Setting Professional Modifier None Typical Low $602.56 Median $1,318.26 Typical High $1,995.26 | Professional | None | $602.56 | $1,318.26 | $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 $741.31 Median $1,949.84 Typical High $3,890.45 | Professional | None | $741.31 | $1,949.84 | $3,890.45 |
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 $316.23 Median $1,513.56 Typical High $1,819.70 | Professional | 52 · Reduced service | $316.23 | $1,513.56 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $602.56 Typical High $741.31 | Professional | 53 · Discontinued | $125.89 | $602.56 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $2,290.87 Typical High $2,754.23 | Professional | 54 · Surgery only | $478.63 | $2,290.87 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $457.09 Typical High $549.54 | Professional | 55 · Aftercare only | $95.50 | $457.09 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $302.00 Typical High $371.54 | Professional | 56 · Pre-op care only | $63.10 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $2,137.96 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $446.68 | $2,137.96 | $2,570.40 |
Where Alaska sits
The same service costs 6.6 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.