How much rates vary
Facilitymedian $676 · 10th to 90th $363 to $5,888Professionalmedian $525 · 10th to 90th $151 to $1,148
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 $676.08 Median $5,888.44 Typical High $14,125.38 | Facility | None | $676.08 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $676.08 Typical High $1,148.15 | Professional | None | $131.83 | $676.08 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $436.52 Typical High $1,348.96 | Facility | None | $263.03 | $436.52 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $234.42 Typical High $676.08 | Professional | None | $134.90 | $234.42 | $676.08 |
Moda Health Setting Facility Modifier None Typical Low $194.98 Median $676.08 Typical High $1,659.59 | Facility | None | $194.98 | $676.08 | $1,659.59 |
Moda Health Setting Professional Modifier None Typical Low $177.83 Median $575.44 Typical High $1,148.15 | Professional | None | $177.83 | $575.44 | $1,148.15 |
Premera BCBS Setting Facility Modifier None Typical Low $316.23 Median $478.63 Typical High $660.69 | Facility | None | $316.23 | $478.63 | $660.69 |
Premera BCBS Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $933.25 | Professional | None | $524.81 | $524.81 | $933.25 |
Providence Setting Facility Modifier None Typical Low $363.08 Median $660.69 Typical High $1,698.24 | Facility | None | $363.08 | $660.69 | $1,698.24 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $295.12 Typical High $676.08 | Professional | None | $125.89 | $295.12 | $676.08 |
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 $134.90 Median $338.84 Typical High $933.25 | Professional | None | $134.90 | $338.84 | $933.25 |
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 $66.07 Median $338.84 Typical High $575.44 | Professional | 52 · Reduced service | $66.07 | $338.84 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $134.90 Typical High $229.09 | Professional | 53 · Discontinued | $26.30 | $134.90 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $512.86 Typical High $870.96 | Professional | 54 · Surgery only | $100.00 | $512.86 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $102.33 Typical High $173.78 | Professional | 55 · Aftercare only | $19.95 | $102.33 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $67.61 Typical High $114.82 | Professional | 56 · Pre-op care only | $13.18 | $67.61 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $478.63 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $93.33 | $478.63 | $812.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $338.84 Typical High $575.44 | Professional | 52 · Reduced service | $83.18 | $338.84 | $575.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $134.90 Typical High $229.09 | Professional | 53 · Discontinued | $33.11 | $134.90 | $229.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $512.86 Typical High $870.96 | Professional | 54 · Surgery only | $123.03 | $512.86 | $870.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $102.33 Typical High $173.78 | Professional | 55 · Aftercare only | $24.55 | $102.33 | $173.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $67.61 Typical High $114.82 | Professional | 56 · Pre-op care only | $16.60 | $67.61 | $114.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $478.63 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $114.82 | $478.63 | $812.83 |
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
$525
AK $525DC $158
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.