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 $1,122.02 Median $5,888.44 Typical High $14,125.38 | Facility | None | $1,122.02 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $1,122.02 Typical High $1,348.96 | Professional | None | $234.42 | $1,122.02 | $1,348.96 |
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 $239.88 Median $380.19 Typical High $831.76 | Professional | None | $239.88 | $380.19 | $831.76 |
Moda Health Setting Facility Modifier None Typical Low $371.54 Median $1,122.02 Typical High $1,819.70 | Facility | None | $371.54 | $1,122.02 | $1,819.70 |
Moda Health Setting Professional Modifier None Typical Low $239.88 Median $831.76 Typical High $1,348.96 | Professional | None | $239.88 | $831.76 | $1,348.96 |
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 $954.99 Median $954.99 Typical High $1,096.48 | Professional | None | $954.99 | $954.99 | $1,096.48 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $630.96 Typical High $1,659.59 | Facility | None | $288.40 | $630.96 | $1,659.59 |
Providence Setting Professional Modifier None Typical Low $213.80 Median $467.74 Typical High $741.31 | Professional | None | $213.80 | $467.74 | $741.31 |
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 $263.03 Median $660.69 Typical High $1,318.26 | Professional | None | $263.03 | $660.69 | $1,318.26 |
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 $117.49 Median $562.34 Typical High $630.96 | Professional | 52 · Reduced service | $117.49 | $562.34 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $223.87 Typical High $251.19 | Professional | 53 · Discontinued | $47.86 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $831.76 Typical High $933.25 | Professional | 54 · Surgery only | $177.83 | $831.76 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $169.82 Typical High $190.55 | Professional | 55 · Aftercare only | $35.48 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $112.20 Typical High $125.89 | Professional | 56 · Pre-op care only | $23.99 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $776.25 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $165.96 | $776.25 | $870.96 |
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
$955
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.