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 $724.44 Median $5,888.44 Typical High $14,125.38 | Facility | None | $724.44 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $724.44 Typical High $851.14 | Professional | None | $158.49 | $724.44 | $851.14 |
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 $158.49 Median $263.03 Typical High $562.34 | Professional | None | $158.49 | $263.03 | $562.34 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $724.44 Typical High $1,202.26 | Facility | None | $251.19 | $724.44 | $1,202.26 |
Moda Health Setting Professional Modifier None Typical Low $162.18 Median $602.56 Typical High $912.01 | Professional | None | $162.18 | $602.56 | $912.01 |
Premera BCBS Setting Facility Modifier None Typical Low $213.80 Median $281.84 Typical High $380.19 | Facility | None | $213.80 | $281.84 | $380.19 |
Premera BCBS Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $758.58 | Professional | None | $616.60 | $616.60 | $758.58 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $630.96 Typical High $1,122.02 | Facility | None | $288.40 | $630.96 | $1,122.02 |
Providence Setting Professional Modifier None Typical Low $141.25 Median $309.03 Typical High $478.63 | Professional | None | $141.25 | $309.03 | $478.63 |
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 $169.82 Median $446.68 Typical High $912.01 | Professional | None | $169.82 | $446.68 | $912.01 |
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 $79.43 Median $363.08 Typical High $426.58 | Professional | 52 · Reduced service | $79.43 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $144.54 Typical High $169.82 | Professional | 53 · Discontinued | $31.62 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $537.03 Typical High $630.96 | Professional | 54 · Surgery only | $117.49 | $537.03 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $107.15 Typical High $128.82 | Professional | 55 · Aftercare only | $23.44 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $72.44 Typical High $85.11 | Professional | 56 · Pre-op care only | $15.85 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $501.19 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $109.65 | $501.19 | $588.84 |
Where Alaska sits
The same service costs 4.6 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
$617
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.