How much rates vary
Facilitymedian $2,138 · 10th to 90th $617 to $6,918Professionalmedian $2,138 · 10th to 90th $617 to $3,162
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $1,778.28 Median $3,890.45 Typical High $14,125.38 | Facility | None | $1,778.28 | $3,890.45 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $2,511.89 Typical High $3,467.37 | Professional | None | $537.03 | $2,511.89 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,238.72 Typical High $6,918.31 | Facility | None | $1,348.96 | $2,238.72 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $831.76 Typical High $1,737.80 | Professional | None | $549.54 | $831.76 | $1,737.80 |
Moda Health Setting Facility Modifier None Typical Low $524.81 Median $1,000.00 Typical High $3,388.44 | Facility | None | $524.81 | $1,000.00 | $3,388.44 |
Moda Health Setting Professional Modifier None Typical Low $588.84 Median $2,238.72 Typical High $3,467.37 | Professional | None | $588.84 | $2,238.72 | $3,467.37 |
Premera BCBS Setting Facility Modifier None Typical Low $676.08 Median $1,905.46 Typical High $2,511.89 | Facility | None | $676.08 | $1,905.46 | $2,511.89 |
Premera BCBS Setting Professional Modifier None Typical Low $2,137.96 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,137.96 | $2,238.72 | $2,238.72 |
Providence Setting Facility Modifier None Typical Low $1,862.09 Median $2,884.03 Typical High $6,918.31 | Facility | None | $1,862.09 | $2,884.03 | $6,918.31 |
Providence Setting Professional Modifier None Typical Low $489.78 Median $1,071.52 Typical High $1,659.59 | Professional | None | $489.78 | $1,071.52 | $1,659.59 |
United Setting Facility Modifier None Typical Low $831.76 Median $1,778.28 Typical High $2,951.21 | Facility | None | $831.76 | $1,778.28 | $2,951.21 |
United Setting Professional Modifier None Typical Low $602.56 Median $1,412.54 Typical High $2,818.38 | Professional | None | $602.56 | $1,412.54 | $2,818.38 |
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 $257.04 Median $1,230.27 Typical High $1,318.26 | Professional | 52 · Reduced service | $257.04 | $1,230.27 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $501.19 Typical High $524.81 | Professional | 53 · Discontinued | $102.33 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $1,862.09 Typical High $1,949.84 | Professional | 54 · Surgery only | $380.19 | $1,862.09 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $371.54 Typical High $389.05 | Professional | 55 · Aftercare only | $75.86 | $371.54 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $251.19 Typical High $263.03 | Professional | 56 · Pre-op care only | $51.29 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $1,737.80 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $354.81 | $1,737.80 | $1,819.70 |
Where Alaska sits
The same service costs 4.0 times more in Colorado 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.
Physician feeFacility fee
CO $4,440FL $1,118
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.