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 $1,819.70 Median $9,772.37 Typical High $16,595.87 | Facility | None | $1,819.70 | $9,772.37 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $891.25 Typical High $2,511.89 | Professional | None | $371.54 | $891.25 | $2,511.89 |
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 $380.19 Median $794.33 Typical High $1,737.80 | Professional | None | $380.19 | $794.33 | $1,737.80 |
Moda Health Setting Facility Modifier None Typical Low $588.84 Median $1,819.70 Typical High $3,548.13 | Facility | None | $588.84 | $1,819.70 | $3,548.13 |
Moda Health Setting Professional Modifier None Typical Low $380.19 Median $1,318.26 Typical High $2,511.89 | Professional | None | $380.19 | $1,318.26 | $2,511.89 |
Premera BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $2,290.87 | Facility | None | $1,071.52 | $1,584.89 | $2,290.87 |
Premera BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,479.11 | $1,479.11 | $2,089.30 |
Providence Setting Facility Modifier None Typical Low $1,584.89 Median $2,454.71 Typical High $5,888.44 | Facility | None | $1,584.89 | $2,454.71 | $5,888.44 |
Providence Setting Professional Modifier None Typical Low $354.81 Median $741.31 Typical High $1,288.25 | Professional | None | $354.81 | $741.31 | $1,288.25 |
United Setting Facility Modifier None Typical Low $831.76 Median $1,778.28 Typical High $2,951.21 | Facility | None | $831.76 | $1,778.28 | $2,951.21 |
United Setting Professional Modifier None Typical Low $512.86 Median $1,380.38 Typical High $2,754.23 | Professional | None | $512.86 | $1,380.38 | $2,754.23 |
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 $186.21 Median $912.01 Typical High $1,258.93 | Professional | 52 · Reduced service | $186.21 | $912.01 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $371.54 Typical High $501.19 | Professional | 53 · Discontinued | $74.13 | $371.54 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $1,380.38 Typical High $1,862.09 | Professional | 54 · Surgery only | $275.42 | $1,380.38 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $275.42 Typical High $371.54 | Professional | 55 · Aftercare only | $54.95 | $275.42 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $181.97 Typical High $251.19 | Professional | 56 · Pre-op care only | $37.15 | $181.97 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $1,288.25 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $257.04 | $1,288.25 | $1,737.80 |
Where Alaska sits
The same service costs 4.8 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
$1,549
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.