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 $398.11 Median $9,772.37 Typical High $16,595.87 | Facility | None | $398.11 | $9,772.37 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $208.93 Typical High $562.34 | Professional | None | $87.10 | $208.93 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $158.49 Typical High $489.78 | Facility | None | $95.50 | $158.49 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $199.53 Typical High $331.13 | Professional | None | $83.18 | $199.53 | $331.13 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $467.74 Typical High $1,122.02 | Facility | None | $173.78 | $467.74 | $1,122.02 |
Moda Health Setting Professional Modifier None Typical Low $95.50 Median $302.00 Typical High $602.56 | Professional | None | $95.50 | $302.00 | $602.56 |
Premera BCBS Setting Facility Modifier None Typical Low $131.83 Median $169.82 Typical High $263.03 | Facility | None | $131.83 | $169.82 | $263.03 |
Premera BCBS Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $426.58 | Professional | None | $323.59 | $426.58 | $426.58 |
Providence Setting Facility Modifier None Typical Low $131.83 Median $288.40 Typical High $776.25 | Facility | None | $131.83 | $288.40 | $776.25 |
Providence Setting Professional Modifier None Typical Low $74.13 Median $165.96 Typical High $269.15 | Professional | None | $74.13 | $165.96 | $269.15 |
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 $107.15 Median $263.03 Typical High $524.81 | Professional | None | $107.15 | $263.03 | $524.81 |
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 $43.65 Median $199.53 Typical High $251.19 | Professional | 52 · Reduced service | $43.65 | $199.53 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $79.43 Typical High $102.33 | Professional | 53 · Discontinued | $17.38 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $302.00 Typical High $380.19 | Professional | 54 · Surgery only | $66.07 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $60.26 Typical High $75.86 | Professional | 55 · Aftercare only | $13.18 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $39.81 Typical High $51.29 | Professional | 56 · Pre-op care only | $8.71 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $281.84 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $61.66 | $281.84 | $354.81 |
Where Alaska sits
The same service costs 3.9 times more in Alaska than in Florida. 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
$324
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.