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 $1,513.56 Median $7,079.46 Typical High $14,125.38 | Facility | None | $1,513.56 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $1,513.56 Typical High $2,137.96 | Professional | None | $309.03 | $1,513.56 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $724.44 Typical High $2,238.72 | Facility | None | $436.52 | $724.44 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $660.69 Typical High $1,445.44 | Professional | None | $316.23 | $660.69 | $1,445.44 |
Moda Health Setting Facility Modifier None Typical Low $489.78 Median $1,513.56 Typical High $3,019.95 | Facility | None | $489.78 | $1,513.56 | $3,019.95 |
Moda Health Setting Professional Modifier None Typical Low $281.84 Median $501.19 Typical High $2,137.96 | Professional | None | $281.84 | $501.19 | $2,137.96 |
Premera BCBS Setting Facility Modifier None Typical Low $588.84 Median $776.25 Typical High $1,202.26 | Facility | None | $588.84 | $776.25 | $1,202.26 |
Premera BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,258.93 | $1,819.70 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $2,238.72 | Facility | None | $602.56 | $1,318.26 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $288.40 Median $630.96 Typical High $1,096.48 | Professional | None | $288.40 | $630.96 | $1,096.48 |
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 $436.52 Median $1,174.90 Typical High $2,344.23 | Professional | None | $436.52 | $1,174.90 | $2,344.23 |
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 $154.88 Median $758.58 Typical High $1,071.52 | Professional | 52 · Reduced service | $154.88 | $758.58 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $302.00 Typical High $426.58 | Professional | 53 · Discontinued | $61.66 | $302.00 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $1,148.15 Typical High $1,584.89 | Professional | 54 · Surgery only | $234.42 | $1,148.15 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $229.09 Typical High $323.59 | Professional | 55 · Aftercare only | $46.77 | $229.09 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $151.36 Typical High $213.80 | Professional | 56 · Pre-op care only | $30.90 | $151.36 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $1,071.52 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $218.78 | $1,071.52 | $1,479.11 |
Where Alaska sits
The same service costs 4.5 times more in Alaska than in Texas. 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.