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 $933.25 Median $5,888.44 Typical High $14,125.38 | Facility | None | $933.25 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $933.25 Typical High $4,677.35 | Professional | None | $162.18 | $933.25 | $4,677.35 |
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 $208.93 Median $251.19 Typical High $707.95 | Professional | None | $208.93 | $251.19 | $707.95 |
Moda Health Setting Facility Modifier None Typical Low $323.59 Median $933.25 Typical High $1,584.89 | Facility | None | $323.59 | $933.25 | $1,584.89 |
Moda Health Setting Professional Modifier None Typical Low $218.78 Median $912.01 Typical High $1,348.96 | Professional | None | $218.78 | $912.01 | $1,348.96 |
Premera BCBS Setting Facility Modifier None Typical Low $223.87 Median $288.40 Typical High $380.19 | Facility | None | $223.87 | $288.40 | $380.19 |
Premera BCBS Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,000.00 | Professional | None | $831.76 | $831.76 | $1,000.00 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $630.96 Typical High $1,445.44 | Facility | None | $288.40 | $630.96 | $1,445.44 |
Providence Setting Professional Modifier None Typical Low $181.97 Median $416.87 Typical High $602.56 | Professional | None | $181.97 | $416.87 | $602.56 |
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 $213.80 Median $562.34 Typical High $1,122.02 | Professional | None | $213.80 | $562.34 | $1,122.02 |
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 $81.28 Median $467.74 Typical High $549.54 | Professional | 52 · Reduced service | $81.28 | $467.74 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $186.21 Typical High $218.78 | Professional | 53 · Discontinued | $32.36 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $691.83 Typical High $831.76 | Professional | 54 · Surgery only | $120.23 | $691.83 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $141.25 Typical High $165.96 | Professional | 55 · Aftercare only | $23.99 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $93.33 Typical High $109.65 | Professional | 56 · Pre-op care only | $16.22 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $660.69 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $112.20 | $660.69 | $776.25 |
Where Alaska sits
The same service costs 5.0 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
$832
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.