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 $1,412.54 Median $7,079.46 Typical High $14,125.38 | Facility | None | $1,412.54 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $758.58 Typical High $2,041.74 | Professional | None | $288.40 | $758.58 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $707.95 Typical High $2,187.76 | Facility | None | $426.58 | $707.95 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $645.65 Typical High $1,412.54 | Professional | None | $295.12 | $645.65 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $457.09 Median $1,412.54 Typical High $2,951.21 | Facility | None | $457.09 | $1,412.54 | $2,951.21 |
Moda Health Setting Professional Modifier None Typical Low $316.23 Median $1,122.02 Typical High $2,041.74 | Professional | None | $316.23 | $1,122.02 | $2,041.74 |
Premera BCBS Setting Facility Modifier None Typical Low $575.44 Median $776.25 Typical High $1,174.90 | Facility | None | $575.44 | $776.25 | $1,174.90 |
Premera BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,174.90 | $1,737.80 |
Providence Setting Facility Modifier None Typical Low $588.84 Median $1,288.25 Typical High $2,187.76 | Facility | None | $588.84 | $1,288.25 | $2,187.76 |
Providence Setting Professional Modifier None Typical Low $269.15 Median $602.56 Typical High $1,047.13 | Professional | None | $269.15 | $602.56 | $1,047.13 |
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 $416.87 Median $1,122.02 Typical High $2,238.72 | Professional | None | $416.87 | $1,122.02 | $2,238.72 |
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 $707.95 Typical High $1,023.29 | Professional | 52 · Reduced service | $144.54 | $707.95 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $281.84 Typical High $407.38 | Professional | 53 · Discontinued | $57.54 | $281.84 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $1,071.52 Typical High $1,548.82 | Professional | 54 · Surgery only | $218.78 | $1,071.52 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $213.80 Typical High $309.03 | Professional | 55 · Aftercare only | $43.65 | $213.80 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $141.25 Typical High $204.17 | Professional | 56 · Pre-op care only | $28.84 | $141.25 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $1,000.00 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $204.17 | $1,000.00 | $1,445.44 |
Where Alaska sits
The same service costs 4.7 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
$1,175
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.