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 $489.78 Median $5,888.44 Typical High $14,125.38 | Facility | None | $489.78 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $489.78 Typical High $602.56 | Professional | None | $97.72 | $489.78 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $213.80 Typical High $660.69 | Facility | None | $128.82 | $213.80 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $363.08 | Professional | None | $107.15 | $169.82 | $363.08 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $489.78 Typical High $794.33 | Facility | None | $165.96 | $489.78 | $794.33 |
Moda Health Setting Professional Modifier None Typical Low $104.71 Median $467.74 Typical High $602.56 | Professional | None | $104.71 | $467.74 | $602.56 |
Premera BCBS Setting Facility Modifier None Typical Low $154.88 Median $199.53 Typical High $316.23 | Facility | None | $154.88 | $199.53 | $316.23 |
Premera BCBS Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $489.78 | Professional | None | $426.58 | $426.58 | $489.78 |
Providence Setting Facility Modifier None Typical Low $177.83 Median $389.05 Typical High $741.31 | Facility | None | $177.83 | $389.05 | $741.31 |
Providence Setting Professional Modifier None Typical Low $97.72 Median $208.93 Typical High $323.59 | Professional | None | $97.72 | $208.93 | $323.59 |
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 $109.65 Median $295.12 Typical High $602.56 | Professional | None | $109.65 | $295.12 | $602.56 |
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 $52.48 Median $245.47 Typical High $275.42 | Professional | 52 · Reduced service | $52.48 | $245.47 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $97.72 Typical High $109.65 | Professional | 53 · Discontinued | $20.89 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $363.08 Typical High $416.87 | Professional | 54 · Surgery only | $77.62 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $72.44 Typical High $83.18 | Professional | 55 · Aftercare only | $15.85 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $48.98 Typical High $54.95 | Professional | 56 · Pre-op care only | $10.47 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $338.84 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $72.44 | $338.84 | $389.05 |
Where Alaska sits
The same service costs 4.5 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
$427
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.