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 $1,380.38 Median $9,772.37 Typical High $16,595.87 | Facility | None | $1,380.38 | $9,772.37 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $512.86 Typical High $1,479.11 | Professional | None | $269.15 | $512.86 | $1,479.11 |
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 $302.00 Median $446.68 Typical High $954.99 | Professional | None | $302.00 | $446.68 | $954.99 |
Moda Health Setting Facility Modifier None Typical Low $467.74 Median $1,380.38 Typical High $2,089.30 | Facility | None | $467.74 | $1,380.38 | $2,089.30 |
Moda Health Setting Professional Modifier None Typical Low $288.40 Median $954.99 Typical High $1,737.80 | Professional | None | $288.40 | $954.99 | $1,737.80 |
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 $1,202.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,202.26 | $1,318.26 | $1,318.26 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $630.96 Typical High $2,089.30 | Facility | None | $288.40 | $630.96 | $2,089.30 |
Providence Setting Professional Modifier None Typical Low $263.03 Median $602.56 Typical High $891.25 | Professional | None | $263.03 | $602.56 | $891.25 |
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 $794.33 Typical High $1,548.82 | Professional | None | $295.12 | $794.33 | $1,548.82 |
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 $691.83 Typical High $741.31 | Professional | 52 · Reduced service | $138.04 | $691.83 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $275.42 Typical High $295.12 | Professional | 53 · Discontinued | $54.95 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $1,023.29 Typical High $1,096.48 | Professional | 54 · Surgery only | $208.93 | $1,023.29 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $204.17 Typical High $218.78 | Professional | 55 · Aftercare only | $41.69 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $138.04 Typical High $147.91 | Professional | 56 · Pre-op care only | $27.54 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $954.99 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $194.98 | $954.99 | $1,023.29 |
Where Alaska sits
The same service costs 5.5 times more in Alaska than in Utah. 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
$1,202
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.