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 $5,888.44 Typical High $14,125.38 | Facility | None | $1,380.38 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $562.34 Typical High $1,819.70 | Professional | None | $288.40 | $562.34 | $1,819.70 |
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 $309.03 Median $467.74 Typical High $1,000.00 | Professional | None | $309.03 | $467.74 | $1,000.00 |
Moda Health Setting Facility Modifier None Typical Low $323.59 Median $549.54 Typical High $2,137.96 | Facility | None | $323.59 | $549.54 | $2,137.96 |
Moda Health Setting Professional Modifier None Typical Low $288.40 Median $1,047.13 Typical High $1,819.70 | Professional | None | $288.40 | $1,047.13 | $1,819.70 |
Premera BCBS Setting Facility Modifier None Typical Low $223.87 Median $288.40 Typical High $407.38 | Facility | None | $223.87 | $288.40 | $407.38 |
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 $2,454.71 | Facility | None | $288.40 | $630.96 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $269.15 Median $602.56 Typical High $912.01 | Professional | None | $269.15 | $602.56 | $912.01 |
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 $794.33 Typical High $1,621.81 | Professional | None | $309.03 | $794.33 | $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 $144.54 Median $691.83 Typical High $758.58 | Professional | 52 · Reduced service | $144.54 | $691.83 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $275.42 Typical High $302.00 | Professional | 53 · Discontinued | $57.54 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $1,047.13 Typical High $1,122.02 | Professional | 54 · Surgery only | $218.78 | $1,047.13 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $208.93 Typical High $223.87 | Professional | 55 · Aftercare only | $43.65 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $138.04 Typical High $151.36 | Professional | 56 · Pre-op care only | $28.84 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $977.24 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $204.17 | $977.24 | $1,047.13 |
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.