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 $1,047.13 Median $4,677.35 Typical High $14,125.38 | Facility | None | $1,047.13 | $4,677.35 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $977.24 Typical High $1,258.93 | Professional | None | $194.98 | $977.24 | $1,258.93 |
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 $218.78 Median $316.23 Typical High $691.83 | Professional | None | $218.78 | $316.23 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $331.13 Median $977.24 Typical High $1,412.54 | Facility | None | $331.13 | $977.24 | $1,412.54 |
Moda Health Setting Professional Modifier None Typical Low $204.17 Median $758.58 Typical High $1,258.93 | Professional | None | $204.17 | $758.58 | $1,258.93 |
Premera BCBS Setting Facility Modifier None Typical Low $213.80 Median $288.40 Typical High $380.19 | Facility | None | $213.80 | $288.40 | $380.19 |
Premera BCBS Setting Professional Modifier None Typical Low $870.96 Median $912.01 Typical High $912.01 | Professional | None | $870.96 | $912.01 | $912.01 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $630.96 Typical High $1,479.11 | Facility | None | $288.40 | $630.96 | $1,479.11 |
Providence Setting Professional Modifier None Typical Low $194.98 Median $426.58 Typical High $645.65 | Professional | None | $194.98 | $426.58 | $645.65 |
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 $575.44 Typical High $1,096.48 | Professional | None | $208.93 | $575.44 | $1,096.48 |
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 $489.78 Typical High $524.81 | Professional | 52 · Reduced service | $97.72 | $489.78 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $194.98 Typical High $208.93 | Professional | 53 · Discontinued | $38.90 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $741.31 Typical High $776.25 | Professional | 54 · Surgery only | $147.91 | $741.31 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $147.91 Typical High $154.88 | Professional | 55 · Aftercare only | $29.51 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $97.72 Typical High $104.71 | Professional | 56 · Pre-op care only | $19.50 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $691.83 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $138.04 | $691.83 | $724.44 |
Where Alaska sits
The same service costs 5.1 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
$871
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.