How much rates vary
Facilitymedian $537 · 10th to 90th $269 to $5,888Professionalmedian $468 · 10th to 90th $155 to $1,175
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 $616.60 Median $5,888.44 Typical High $14,125.38 | Facility | None | $616.60 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $616.60 Typical High $1,174.90 | Professional | None | $120.23 | $616.60 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $331.13 Typical High $1,023.29 | Facility | None | $199.53 | $331.13 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $229.09 Typical High $660.69 | Professional | None | $123.03 | $229.09 | $660.69 |
Moda Health Setting Facility Modifier None Typical Low $181.97 Median $616.60 Typical High $1,698.24 | Facility | None | $181.97 | $616.60 | $1,698.24 |
Moda Health Setting Professional Modifier None Typical Low $218.78 Median $616.60 Typical High $1,174.90 | Professional | None | $218.78 | $616.60 | $1,174.90 |
Premera BCBS Setting Facility Modifier None Typical Low $194.98 Median $316.23 Typical High $537.03 | Facility | None | $194.98 | $316.23 | $537.03 |
Premera BCBS Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $933.25 | Professional | None | $467.74 | $467.74 | $933.25 |
Providence Setting Facility Modifier None Typical Low $275.42 Median $602.56 Typical High $1,698.24 | Facility | None | $275.42 | $602.56 | $1,698.24 |
Providence Setting Professional Modifier None Typical Low $114.82 Median $288.40 Typical High $660.69 | Professional | None | $114.82 | $288.40 | $660.69 |
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 $120.23 Median $302.00 Typical High $831.76 | Professional | None | $120.23 | $302.00 | $831.76 |
12 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 $60.26 Median $309.03 Typical High $588.84 | Professional | 52 · Reduced service | $60.26 | $309.03 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $123.03 Typical High $234.42 | Professional | 53 · Discontinued | $23.99 | $123.03 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $467.74 Typical High $891.25 | Professional | 54 · Surgery only | $91.20 | $467.74 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $93.33 Typical High $177.83 | Professional | 55 · Aftercare only | $18.20 | $93.33 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $61.66 Typical High $117.49 | Professional | 56 · Pre-op care only | $12.02 | $61.66 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $436.52 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $85.11 | $436.52 | $831.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $309.03 Typical High $588.84 | Professional | 52 · Reduced service | $75.86 | $309.03 | $588.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $123.03 Typical High $234.42 | Professional | 53 · Discontinued | $30.20 | $123.03 | $234.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $467.74 Typical High $891.25 | Professional | 54 · Surgery only | $112.20 | $467.74 | $891.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $93.33 Typical High $177.83 | Professional | 55 · Aftercare only | $22.39 | $93.33 | $177.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $61.66 Typical High $117.49 | Professional | 56 · Pre-op care only | $15.14 | $61.66 | $117.49 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $436.52 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $104.71 | $436.52 | $831.76 |
Where Alaska sits
The same service costs 3.5 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
$468
AK $468TX $135
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.