How much rates vary
Facilitymedian $1,622 · 10th to 90th $794 to $5,888Professionalmedian $447 · 10th to 90th $129 to $1,072
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 $112.20 Median $562.34 Typical High $1,071.52 | Professional | None | $112.20 | $562.34 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $5,248.07 | Facility | None | $1,023.29 | $1,698.24 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $229.09 Typical High $630.96 | Professional | None | $117.49 | $229.09 | $630.96 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $812.83 Typical High $1,621.81 | Facility | None | $165.96 | $812.83 | $1,621.81 |
Moda Health Setting Professional Modifier None Typical Low $147.91 Median $524.81 Typical High $1,071.52 | Professional | None | $147.91 | $524.81 | $1,071.52 |
Premera BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $2,041.74 | Facility | None | $1,000.00 | $1,380.38 | $2,041.74 |
Premera BCBS Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $870.96 | Professional | None | $446.68 | $446.68 | $870.96 |
Providence Setting Facility Modifier None Typical Low $794.33 Median $1,548.82 Typical High $5,248.07 | Facility | None | $794.33 | $1,548.82 | $5,248.07 |
Providence Setting Professional Modifier None Typical Low $104.71 Median $275.42 Typical High $630.96 | Professional | None | $104.71 | $275.42 | $630.96 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $3,162.28 Typical High $4,265.80 | Facility | None | $1,096.48 | $3,162.28 | $4,265.80 |
United Setting Professional Modifier None Typical Low $112.20 Median $275.42 Typical High $758.58 | Professional | None | $112.20 | $275.42 | $758.58 |
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 $56.23 Median $281.84 Typical High $537.03 | Professional | 52 · Reduced service | $56.23 | $281.84 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $112.20 Typical High $213.80 | Professional | 53 · Discontinued | $22.39 | $112.20 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $426.58 Typical High $794.33 | Professional | 54 · Surgery only | $83.18 | $426.58 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $85.11 Typical High $162.18 | Professional | 55 · Aftercare only | $16.98 | $85.11 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $56.23 Typical High $107.15 | Professional | 56 · Pre-op care only | $11.22 | $56.23 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $398.11 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $77.62 | $398.11 | $741.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $281.84 Typical High $537.03 | Professional | 52 · Reduced service | $69.18 | $281.84 | $537.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $112.20 Typical High $213.80 | Professional | 53 · Discontinued | $27.54 | $112.20 | $213.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $426.58 Typical High $794.33 | Professional | 54 · Surgery only | $104.71 | $426.58 | $794.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $85.11 Typical High $162.18 | Professional | 55 · Aftercare only | $20.89 | $85.11 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $56.23 Typical High $107.15 | Professional | 56 · Pre-op care only | $13.80 | $56.23 | $107.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $398.11 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $97.72 | $398.11 | $741.31 |
Where Alaska sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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
$447
AK $447DC $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.