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 $10,715.19 Typical High $14,125.38 | Facility | None | $1,380.38 | $10,715.19 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $1,380.38 Typical High $1,548.82 | Professional | None | $288.40 | $1,380.38 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,238.72 Typical High $6,918.31 | Facility | None | $1,348.96 | $2,238.72 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $489.78 Typical High $1,047.13 | Professional | None | $288.40 | $489.78 | $1,047.13 |
Moda Health Setting Facility Modifier None Typical Low $457.09 Median $1,380.38 Typical High $2,187.76 | Facility | None | $457.09 | $1,380.38 | $2,187.76 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $1,096.48 Typical High $1,778.28 | Professional | None | $309.03 | $1,096.48 | $1,778.28 |
Premera BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $2,187.76 Typical High $2,951.21 | Facility | None | $1,412.54 | $2,187.76 | $2,951.21 |
Premera BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,288.25 | Professional | None | $1,148.15 | $1,148.15 | $1,288.25 |
Providence Setting Facility Modifier None Typical Low $1,412.54 Median $2,137.96 Typical High $6,918.31 | Facility | None | $1,412.54 | $2,137.96 | $6,918.31 |
Providence Setting Professional Modifier None Typical Low $269.15 Median $575.44 Typical High $954.99 | Professional | None | $269.15 | $575.44 | $954.99 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $6,165.95 Typical High $8,912.51 | Facility | None | $1,905.46 | $6,165.95 | $8,912.51 |
United Setting Professional Modifier None Typical Low $331.13 Median $831.76 Typical High $1,659.59 | Professional | None | $331.13 | $831.76 | $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 $144.54 Median $691.83 Typical High $776.25 | Professional | 52 · Reduced service | $144.54 | $691.83 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $275.42 Typical High $309.03 | Professional | 53 · Discontinued | $57.54 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $1,047.13 Typical High $1,148.15 | Professional | 54 · Surgery only | $213.80 | $1,047.13 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $208.93 Typical High $229.09 | Professional | 55 · Aftercare only | $42.66 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $138.04 Typical High $154.88 | Professional | 56 · Pre-op care only | $28.84 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $977.24 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $199.53 | $977.24 | $1,071.52 |
Where Alaska sits
The same service costs 6.8 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
$1,288
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.