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 $1,548.82 Median $7,079.46 Typical High $14,125.38 | Facility | None | $1,548.82 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $575.44 Typical High $2,187.76 | Professional | None | $323.59 | $575.44 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,905.46 Typical High $5,888.44 | Facility | None | $1,148.15 | $1,905.46 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $707.95 Typical High $1,513.56 | Professional | None | $323.59 | $707.95 | $1,513.56 |
Moda Health Setting Facility Modifier None Typical Low $501.19 Median $1,995.26 Typical High $3,090.30 | Facility | None | $501.19 | $1,995.26 | $3,090.30 |
Moda Health Setting Professional Modifier None Typical Low $346.74 Median $1,174.90 Typical High $2,187.76 | Professional | None | $346.74 | $1,174.90 | $2,187.76 |
Premera BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $1,737.80 Typical High $2,454.71 | Facility | None | $1,148.15 | $1,737.80 | $2,454.71 |
Premera BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,258.93 | $1,862.09 |
Providence Setting Facility Modifier None Typical Low $1,584.89 Median $2,238.72 Typical High $5,888.44 | Facility | None | $1,584.89 | $2,238.72 | $5,888.44 |
Providence Setting Professional Modifier None Typical Low $302.00 Median $645.65 Typical High $1,122.02 | Professional | None | $302.00 | $645.65 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $3,162.28 Typical High $4,265.80 | Facility | None | $1,096.48 | $3,162.28 | $4,265.80 |
United Setting Professional Modifier None Typical Low $457.09 Median $1,202.26 Typical High $2,398.83 | Professional | None | $457.09 | $1,202.26 | $2,398.83 |
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 $158.49 Median $776.25 Typical High $1,096.48 | Professional | 52 · Reduced service | $158.49 | $776.25 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $309.03 Typical High $436.52 | Professional | 53 · Discontinued | $63.10 | $309.03 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $1,148.15 Typical High $1,621.81 | Professional | 54 · Surgery only | $239.88 | $1,148.15 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $234.42 Typical High $323.59 | Professional | 55 · Aftercare only | $47.86 | $234.42 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $154.88 Typical High $218.78 | Professional | 56 · Pre-op care only | $31.62 | $154.88 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $1,071.52 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $223.87 | $1,071.52 | $1,513.56 |
Where Alaska sits
The same service costs 4.9 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
$1,413
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.