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 $1,412.54 Median $5,888.44 Typical High $14,125.38 | Facility | None | $1,412.54 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $1,412.54 Typical High $1,778.28 | Professional | None | $275.42 | $1,412.54 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $346.74 Typical High $1,071.52 | Facility | None | $208.93 | $346.74 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $457.09 Typical High $977.24 | Professional | None | $316.23 | $457.09 | $977.24 |
Moda Health Setting Facility Modifier None Typical Low $467.74 Median $1,412.54 Typical High $2,137.96 | Facility | None | $467.74 | $1,412.54 | $2,137.96 |
Moda Health Setting Professional Modifier None Typical Low $288.40 Median $1,202.26 Typical High $1,778.28 | Professional | None | $288.40 | $1,202.26 | $1,778.28 |
Premera BCBS Setting Facility Modifier None Typical Low $223.87 Median $309.03 Typical High $676.08 | Facility | None | $223.87 | $309.03 | $676.08 |
Premera BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,288.25 | Professional | None | $1,230.27 | $1,230.27 | $1,288.25 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $630.96 Typical High $2,398.83 | Facility | None | $288.40 | $630.96 | $2,398.83 |
Providence Setting Professional Modifier None Typical Low $269.15 Median $616.60 Typical High $933.25 | Professional | None | $269.15 | $616.60 | $933.25 |
United Setting Facility Modifier None Typical Low $478.63 Median $954.99 Typical High $1,174.90 | Facility | None | $478.63 | $954.99 | $1,174.90 |
United Setting Professional Modifier None Typical Low $295.12 Median $812.83 Typical High $1,659.59 | Professional | None | $295.12 | $812.83 | $1,659.59 |
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 $138.04 Median $707.95 Typical High $741.31 | Professional | 52 · Reduced service | $138.04 | $707.95 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $281.84 Typical High $295.12 | Professional | 53 · Discontinued | $54.95 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $1,071.52 Typical High $1,122.02 | Professional | 54 · Surgery only | $208.93 | $1,071.52 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $213.80 Typical High $223.87 | Professional | 55 · Aftercare only | $41.69 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $141.25 Typical High $147.91 | Professional | 56 · Pre-op care only | $27.54 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $1,000.00 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $194.98 | $1,000.00 | $1,047.13 |
Where Alaska sits
The same service costs 5.5 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
$1,230
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.