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 $575.44 Median $5,888.44 Typical High $14,125.38 | Facility | None | $575.44 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $223.87 Typical High $575.44 | Professional | None | $112.20 | $223.87 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $223.87 Typical High $691.83 | Facility | None | $138.04 | $223.87 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $389.05 | Professional | None | $125.89 | $181.97 | $389.05 |
Moda Health Setting Facility Modifier None Typical Low $199.53 Median $338.84 Typical High $831.76 | Facility | None | $199.53 | $338.84 | $831.76 |
Moda Health Setting Professional Modifier None Typical Low $117.49 Median $407.38 Typical High $691.83 | Professional | None | $117.49 | $407.38 | $691.83 |
Premera BCBS Setting Facility Modifier None Typical Low $165.96 Median $213.80 Typical High $331.13 | Facility | None | $165.96 | $213.80 | $331.13 |
Premera BCBS Setting Professional Modifier None Typical Low $501.19 Median $512.86 Typical High $512.86 | Professional | None | $501.19 | $512.86 | $512.86 |
Providence Setting Facility Modifier None Typical Low $186.21 Median $407.38 Typical High $891.25 | Facility | None | $186.21 | $407.38 | $891.25 |
Providence Setting Professional Modifier None Typical Low $114.82 Median $251.19 Typical High $380.19 | Professional | None | $114.82 | $251.19 | $380.19 |
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 $114.82 Median $309.03 Typical High $660.69 | Professional | None | $114.82 | $309.03 | $660.69 |
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 $54.95 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $54.95 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $22.39 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $83.18 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $16.60 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $10.96 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $77.62 | $407.38 | $407.38 |
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
$501
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.