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 $562.34 Median $5,888.44 Typical High $14,125.38 | Facility | None | $562.34 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $251.19 Typical High $831.76 | Professional | None | $123.03 | $251.19 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $194.98 Typical High $602.56 | Facility | None | $117.49 | $194.98 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $218.78 Typical High $478.63 | Professional | None | $123.03 | $218.78 | $478.63 |
Moda Health Setting Facility Modifier None Typical Low $177.83 Median $707.95 Typical High $1,000.00 | Facility | None | $177.83 | $707.95 | $1,000.00 |
Moda Health Setting Professional Modifier None Typical Low $125.89 Median $398.11 Typical High $870.96 | Professional | None | $125.89 | $398.11 | $870.96 |
Premera BCBS Setting Facility Modifier None Typical Low $128.82 Median $190.55 Typical High $269.15 | Facility | None | $128.82 | $190.55 | $269.15 |
Premera BCBS Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $630.96 | Professional | None | $501.19 | $501.19 | $630.96 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $354.81 Typical High $724.44 | Facility | None | $162.18 | $354.81 | $724.44 |
Providence Setting Professional Modifier None Typical Low $120.23 Median $251.19 Typical High $398.11 | Professional | None | $120.23 | $251.19 | $398.11 |
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 $177.83 Median $380.19 Typical High $758.58 | Professional | None | $177.83 | $380.19 | $758.58 |
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 $63.10 Median $281.84 Typical High $346.74 | Professional | 52 · Reduced service | $63.10 | $281.84 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $112.20 Typical High $141.25 | Professional | 53 · Discontinued | $25.12 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $426.58 Typical High $524.81 | Professional | 54 · Surgery only | $93.33 | $426.58 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $85.11 Typical High $104.71 | Professional | 55 · Aftercare only | $18.62 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $56.23 Typical High $70.79 | Professional | 56 · Pre-op care only | $12.59 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $398.11 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $87.10 | $398.11 | $489.78 |
Where Alaska sits
The same service costs 3.9 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
$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.