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 $891.25 Median $10,715.19 Typical High $14,125.38 | Facility | None | $891.25 | $10,715.19 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $891.25 Typical High $10,715.19 | Professional | None | $186.21 | $891.25 | $10,715.19 |
Cigna Setting Facility Modifier None Typical Low $7,244.36 Median $12,022.64 Typical High $37,153.52 | Facility | None | $7,244.36 | $12,022.64 | $37,153.52 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $446.68 Typical High $1,071.52 | Professional | None | $190.55 | $446.68 | $1,071.52 |
Moda Health Setting Facility Modifier None Typical Low $295.12 Median $891.25 Typical High $2,187.76 | Facility | None | $295.12 | $891.25 | $2,187.76 |
Moda Health Setting Professional Modifier None Typical Low $302.00 Median $891.25 Typical High $1,698.24 | Professional | None | $302.00 | $891.25 | $1,698.24 |
Premera BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $7,762.47 Typical High $9,332.54 | Facility | None | $3,235.94 | $7,762.47 | $9,332.54 |
Premera BCBS Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,348.96 | Professional | None | $741.31 | $741.31 | $1,348.96 |
Providence Setting Facility Modifier None Typical Low $1,318.26 Median $10,000.00 Typical High $21,877.62 | Facility | None | $1,318.26 | $10,000.00 | $21,877.62 |
Providence Setting Professional Modifier None Typical Low $173.78 Median $446.68 Typical High $794.33 | Professional | None | $173.78 | $446.68 | $794.33 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $6,165.95 Typical High $8,912.51 | Facility | None | $1,905.46 | $6,165.95 | $8,912.51 |
United Setting Professional Modifier None Typical Low $323.59 Median $851.14 Typical High $1,698.24 | Professional | None | $323.59 | $851.14 | $1,698.24 |
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 $93.33 Median $446.68 Typical High $758.58 | Professional | 52 · Reduced service | $93.33 | $446.68 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $177.83 Typical High $302.00 | Professional | 53 · Discontinued | $37.15 | $177.83 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $676.08 Typical High $1,148.15 | Professional | 54 · Surgery only | $141.25 | $676.08 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $134.90 Typical High $229.09 | Professional | 55 · Aftercare only | $28.18 | $134.90 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $89.13 Typical High $151.36 | Professional | 56 · Pre-op care only | $18.62 | $89.13 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $630.96 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $131.83 | $630.96 | $1,071.52 |
Where Alaska sits
The same service costs 5.1 times more in Alaska than in Texas. 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
$977
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.