How much rates vary
Facilitymedian $1,047 · 10th to 90th $562 to $4,677Professionalmedian $813 · 10th to 90th $240 to $1,778
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 $1,047.13 Median $5,888.44 Typical High $14,125.38 | Facility | None | $1,047.13 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $1,047.13 Typical High $1,778.28 | Professional | None | $208.93 | $1,047.13 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $741.31 Typical High $2,290.87 | Facility | None | $446.68 | $741.31 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $346.74 Typical High $1,023.29 | Professional | None | $194.98 | $346.74 | $1,023.29 |
Moda Health Setting Facility Modifier None Typical Low $309.03 Median $1,047.13 Typical High $2,511.89 | Facility | None | $309.03 | $1,047.13 | $2,511.89 |
Moda Health Setting Professional Modifier None Typical Low $346.74 Median $1,047.13 Typical High $1,778.28 | Professional | None | $346.74 | $1,047.13 | $1,778.28 |
Premera BCBS Setting Facility Modifier None Typical Low $478.63 Median $676.08 Typical High $812.83 | Facility | None | $478.63 | $676.08 | $812.83 |
Premera BCBS Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,445.44 | Professional | None | $812.83 | $812.83 | $1,445.44 |
Providence Setting Facility Modifier None Typical Low $616.60 Median $1,047.13 Typical High $2,290.87 | Facility | None | $616.60 | $1,047.13 | $2,290.87 |
Providence Setting Professional Modifier None Typical Low $169.82 Median $436.52 Typical High $1,023.29 | Professional | None | $169.82 | $436.52 | $1,023.29 |
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 $204.17 Median $512.86 Typical High $1,412.54 | Professional | None | $204.17 | $512.86 | $1,412.54 |
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 $104.71 Median $524.81 Typical High $870.96 | Professional | 52 · Reduced service | $104.71 | $524.81 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $208.93 Typical High $354.81 | Professional | 53 · Discontinued | $41.69 | $208.93 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $776.25 Typical High $1,318.26 | Professional | 54 · Surgery only | $154.88 | $776.25 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $154.88 Typical High $263.03 | Professional | 55 · Aftercare only | $30.90 | $154.88 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $104.71 Typical High $177.83 | Professional | 56 · Pre-op care only | $20.89 | $104.71 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $724.44 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $144.54 | $724.44 | $1,230.27 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $524.81 Typical High $870.96 | Professional | 52 · Reduced service | $125.89 | $524.81 | $870.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $208.93 Typical High $354.81 | Professional | 53 · Discontinued | $51.29 | $208.93 | $354.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $776.25 Typical High $1,318.26 | Professional | 54 · Surgery only | $190.55 | $776.25 | $1,318.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $154.88 Typical High $263.03 | Professional | 55 · Aftercare only | $38.02 | $154.88 | $263.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $104.71 Typical High $177.83 | Professional | 56 · Pre-op care only | $25.70 | $104.71 | $177.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $724.44 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $177.83 | $724.44 | $1,230.27 |
Where Alaska sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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
$813
AK $813KY $234
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.