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 $1,949.84 Median $7,079.46 Typical High $14,125.38 | Facility | None | $1,949.84 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $2,754.23 Typical High $7,079.46 | Professional | None | $602.56 | $2,754.23 | $7,079.46 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $5,248.07 | Facility | None | $1,023.29 | $1,698.24 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $1,096.48 Typical High $2,137.96 | Professional | None | $616.60 | $1,096.48 | $2,137.96 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $2,754.23 Typical High $4,677.35 | Facility | None | $891.25 | $2,754.23 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $660.69 Median $2,454.71 Typical High $3,715.35 | Professional | None | $660.69 | $2,454.71 | $3,715.35 |
Premera BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $2,041.74 | Facility | None | $1,071.52 | $1,479.11 | $2,041.74 |
Premera BCBS Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,884.03 | Professional | None | $2,398.83 | $2,398.83 | $2,884.03 |
Providence Setting Facility Modifier None Typical Low $1,412.54 Median $2,754.23 Typical High $5,248.07 | Facility | None | $1,412.54 | $2,754.23 | $5,248.07 |
Providence Setting Professional Modifier None Typical Low $549.54 Median $1,230.27 Typical High $1,778.28 | Professional | None | $549.54 | $1,230.27 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $3,162.28 Typical High $4,265.80 | Facility | None | $1,096.48 | $3,162.28 | $4,265.80 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,698.24 Typical High $3,388.44 | Professional | None | $660.69 | $1,698.24 | $3,388.44 |
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 $302.00 Median $1,380.38 Typical High $1,621.81 | Professional | 52 · Reduced service | $302.00 | $1,380.38 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $549.54 Typical High $660.69 | Professional | 53 · Discontinued | $120.23 | $549.54 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $2,089.30 Typical High $2,454.71 | Professional | 54 · Surgery only | $446.68 | $2,089.30 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $416.87 Typical High $489.78 | Professional | 55 · Aftercare only | $89.13 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $275.42 Typical High $323.59 | Professional | 56 · Pre-op care only | $60.26 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $1,949.84 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $416.87 | $1,949.84 | $2,290.87 |
Where Alaska sits
The same service costs 5.6 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
$2,399
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.