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 $912.01 Median $5,888.44 Typical High $14,125.38 | Facility | None | $912.01 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $416.87 Typical High $1,000.00 | Professional | None | $190.55 | $416.87 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $346.74 Typical High $1,071.52 | Facility | None | $208.93 | $346.74 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $676.08 | Professional | None | $204.17 | $323.59 | $676.08 |
Moda Health Setting Facility Modifier None Typical Low $309.03 Median $912.01 Typical High $1,445.44 | Facility | None | $309.03 | $912.01 | $1,445.44 |
Moda Health Setting Professional Modifier None Typical Low $194.98 Median $691.83 Typical High $1,148.15 | Professional | None | $194.98 | $691.83 | $1,148.15 |
Premera BCBS Setting Facility Modifier None Typical Low $213.80 Median $288.40 Typical High $407.38 | Facility | None | $213.80 | $288.40 | $407.38 |
Premera BCBS Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $891.25 | Professional | None | $794.33 | $891.25 | $891.25 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $630.96 Typical High $1,412.54 | Facility | None | $288.40 | $630.96 | $1,412.54 |
Providence Setting Professional Modifier None Typical Low $181.97 Median $398.11 Typical High $616.60 | Professional | None | $181.97 | $398.11 | $616.60 |
United Setting Facility Modifier None Typical Low $478.63 Median $954.99 Typical High $1,174.90 | Facility | None | $478.63 | $954.99 | $1,174.90 |
United Setting Professional Modifier None Typical Low $208.93 Median $537.03 Typical High $1,071.52 | Professional | None | $208.93 | $537.03 | $1,071.52 |
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 $97.72 Median $457.09 Typical High $501.19 | Professional | 52 · Reduced service | $97.72 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $186.21 Typical High $199.53 | Professional | 53 · Discontinued | $38.90 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $691.83 Typical High $758.58 | Professional | 54 · Surgery only | $147.91 | $691.83 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $138.04 Typical High $151.36 | Professional | 55 · Aftercare only | $29.51 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $91.20 Typical High $100.00 | Professional | 56 · Pre-op care only | $19.50 | $91.20 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $645.65 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $138.04 | $645.65 | $707.95 |
Where Alaska sits
The same service costs 4.8 times more in Alaska than in Florida. 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
$794
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.