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 $1,621.81 Median $4,677.35 Typical High $14,125.38 | Facility | None | $1,621.81 | $4,677.35 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $602.56 Typical High $1,995.26 | Professional | None | $281.84 | $602.56 | $1,995.26 |
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 $346.74 Median $478.63 Typical High $1,023.29 | Professional | None | $346.74 | $478.63 | $1,023.29 |
Moda Health Setting Facility Modifier None Typical Low $354.81 Median $1,122.02 Typical High $2,187.76 | Facility | None | $354.81 | $1,122.02 | $2,187.76 |
Moda Health Setting Professional Modifier None Typical Low $302.00 Median $1,174.90 Typical High $1,995.26 | Professional | None | $302.00 | $1,174.90 | $1,995.26 |
Premera BCBS Setting Facility Modifier None Typical Low $213.80 Median $288.40 Typical High $407.38 | Facility | None | $213.80 | $288.40 | $407.38 |
Premera BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,380.38 | $1,445.44 | $1,445.44 |
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 $295.12 Median $691.83 Typical High $977.24 | Professional | None | $295.12 | $691.83 | $977.24 |
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 $309.03 Median $870.96 Typical High $1,659.59 | Professional | None | $309.03 | $870.96 | $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 $151.36 Median $776.25 Typical High $812.83 | Professional | 52 · Reduced service | $151.36 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $309.03 Typical High $323.59 | Professional | 53 · Discontinued | $60.26 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $1,148.15 Typical High $1,202.26 | Professional | 54 · Surgery only | $229.09 | $1,148.15 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $229.09 Typical High $239.88 | Professional | 55 · Aftercare only | $45.71 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $154.88 Typical High $162.18 | Professional | 56 · Pre-op care only | $30.20 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $1,071.52 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $213.80 | $1,071.52 | $1,122.02 |
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
$1,380
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.