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 $1,445.44 Median $5,888.44 Typical High $14,125.38 | Facility | None | $1,445.44 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $660.69 Typical High $1,862.09 | Professional | None | $295.12 | $660.69 | $1,862.09 |
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 $323.59 Median $478.63 Typical High $1,023.29 | Professional | None | $323.59 | $478.63 | $1,023.29 |
Moda Health Setting Facility Modifier None Typical Low $489.78 Median $1,445.44 Typical High $2,238.72 | Facility | None | $489.78 | $1,445.44 | $2,238.72 |
Moda Health Setting Professional Modifier None Typical Low $302.00 Median $1,096.48 Typical High $1,905.46 | Professional | None | $302.00 | $1,096.48 | $1,905.46 |
Premera BCBS Setting Facility Modifier None Typical Low $223.87 Median $288.40 Typical High $380.19 | Facility | None | $223.87 | $288.40 | $380.19 |
Premera BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,258.93 | $1,380.38 | $1,380.38 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $630.96 Typical High $2,570.40 | Facility | None | $288.40 | $630.96 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $281.84 Median $630.96 Typical High $933.25 | Professional | None | $281.84 | $630.96 | $933.25 |
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 $309.03 Median $851.14 Typical High $1,621.81 | Professional | None | $309.03 | $851.14 | $1,621.81 |
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 $147.91 Median $724.44 Typical High $776.25 | Professional | 52 · Reduced service | $147.91 | $724.44 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $288.40 Typical High $309.03 | Professional | 53 · Discontinued | $58.88 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $1,096.48 Typical High $1,174.90 | Professional | 54 · Surgery only | $218.78 | $1,096.48 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $218.78 Typical High $234.42 | Professional | 55 · Aftercare only | $44.67 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $144.54 Typical High $154.88 | Professional | 56 · Pre-op care only | $29.51 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $1,023.29 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $204.17 | $1,023.29 | $1,096.48 |
Where Alaska sits
The same service costs 5.8 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
$1,259
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.