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 $549.54 Median $5,888.44 Typical High $14,125.38 | Facility | None | $549.54 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $275.42 Typical High $676.08 | Professional | None | $134.90 | $275.42 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $223.87 Typical High $676.08 | Facility | None | $134.90 | $223.87 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $263.03 Typical High $426.58 | Professional | None | $117.49 | $263.03 | $426.58 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $549.54 Typical High $891.25 | Facility | None | $173.78 | $549.54 | $891.25 |
Moda Health Setting Professional Modifier None Typical Low $141.25 Median $354.81 Typical High $676.08 | Professional | None | $141.25 | $354.81 | $676.08 |
Premera BCBS Setting Facility Modifier None Typical Low $147.91 Median $223.87 Typical High $316.23 | Facility | None | $147.91 | $223.87 | $316.23 |
Premera BCBS Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $562.34 | Professional | None | $489.78 | $489.78 | $562.34 |
Providence Setting Facility Modifier None Typical Low $186.21 Median $398.11 Typical High $912.01 | Facility | None | $186.21 | $398.11 | $912.01 |
Providence Setting Professional Modifier None Typical Low $112.20 Median $245.47 Typical High $371.54 | Professional | None | $112.20 | $245.47 | $371.54 |
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 $162.18 Median $338.84 Typical High $776.25 | Professional | None | $162.18 | $338.84 | $776.25 |
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 $61.66 Median $275.42 Typical High $309.03 | Professional | 52 · Reduced service | $61.66 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $109.65 Typical High $125.89 | Professional | 53 · Discontinued | $24.55 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $407.38 Typical High $467.74 | Professional | 54 · Surgery only | $93.33 | $407.38 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $83.18 Typical High $93.33 | Professional | 55 · Aftercare only | $18.62 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $54.95 Typical High $63.10 | Professional | 56 · Pre-op care only | $12.30 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $380.19 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $87.10 | $380.19 | $436.52 |
Where Alaska sits
The same service costs 4.2 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
$490
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.