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 $371.54 Median $5,888.44 Typical High $14,125.38 | Facility | None | $371.54 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $177.83 Typical High $549.54 | Professional | None | $75.86 | $177.83 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $229.09 Typical High $707.95 | Facility | None | $138.04 | $229.09 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $147.91 Typical High $331.13 | Professional | None | $81.28 | $147.91 | $331.13 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $371.54 Typical High $776.25 | Facility | None | $117.49 | $371.54 | $776.25 |
Moda Health Setting Professional Modifier None Typical Low $81.28 Median $309.03 Typical High $575.44 | Professional | None | $81.28 | $309.03 | $575.44 |
Premera BCBS Setting Facility Modifier None Typical Low $151.36 Median $208.93 Typical High $676.08 | Facility | None | $151.36 | $208.93 | $676.08 |
Premera BCBS Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $478.63 | Professional | None | $323.59 | $323.59 | $478.63 |
Providence Setting Facility Modifier None Typical Low $190.55 Median $371.54 Typical High $870.96 | Facility | None | $190.55 | $371.54 | $870.96 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $162.18 Typical High $263.03 | Professional | None | $72.44 | $162.18 | $263.03 |
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 $112.20 Median $263.03 Typical High $537.03 | Professional | None | $112.20 | $263.03 | $537.03 |
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 $39.81 Median $186.21 Typical High $275.42 | Professional | 52 · Reduced service | $39.81 | $186.21 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $74.13 Typical High $109.65 | Professional | 53 · Discontinued | $15.85 | $74.13 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $281.84 Typical High $407.38 | Professional | 54 · Surgery only | $60.26 | $281.84 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $56.23 Typical High $81.28 | Professional | 55 · Aftercare only | $12.02 | $56.23 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $37.15 Typical High $54.95 | Professional | 56 · Pre-op care only | $7.94 | $37.15 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $263.03 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $56.23 | $263.03 | $380.19 |
Where Alaska sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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.