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 $1,258.93 Median $5,888.44 Typical High $14,125.38 | Facility | None | $1,258.93 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $478.63 Typical High $1,513.56 | Professional | None | $239.88 | $478.63 | $1,513.56 |
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 $275.42 Median $407.38 Typical High $891.25 | Professional | None | $275.42 | $407.38 | $891.25 |
Moda Health Setting Facility Modifier None Typical Low $426.58 Median $1,258.93 Typical High $1,995.26 | Facility | None | $426.58 | $1,258.93 | $1,995.26 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $1,000.00 Typical High $1,621.81 | Professional | None | $245.47 | $1,000.00 | $1,621.81 |
Premera BCBS Setting Facility Modifier None Typical Low $213.80 Median $288.40 Typical High $380.19 | Facility | None | $213.80 | $288.40 | $380.19 |
Premera BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,230.27 | Professional | None | $1,096.48 | $1,096.48 | $1,230.27 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $630.96 Typical High $1,949.84 | Facility | None | $288.40 | $630.96 | $1,949.84 |
Providence Setting Professional Modifier None Typical Low $239.88 Median $549.54 Typical High $812.83 | Professional | None | $239.88 | $549.54 | $812.83 |
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 $275.42 Median $724.44 Typical High $1,412.54 | Professional | None | $275.42 | $724.44 | $1,412.54 |
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 $123.03 Median $630.96 Typical High $691.83 | Professional | 52 · Reduced service | $123.03 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $251.19 Typical High $275.42 | Professional | 53 · Discontinued | $48.98 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $933.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $186.21 | $933.25 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $186.21 Typical High $208.93 | Professional | 55 · Aftercare only | $37.15 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $125.89 Typical High $138.04 | Professional | 56 · Pre-op care only | $24.55 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $870.96 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $173.78 | $870.96 | $977.24 |
Where Alaska sits
The same service costs 5.4 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
$1,096
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.