How much rates vary
Facilitymedian $1,096 · 10th to 90th $501 to $4,677Professionalmedian $912 · 10th to 90th $269 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 $1,174.90 Median $5,888.44 Typical High $14,125.38 | Facility | None | $1,174.90 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $1,174.90 Typical High $1,778.28 | Professional | None | $229.09 | $1,174.90 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $660.69 Typical High $2,041.74 | Facility | None | $398.11 | $660.69 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $363.08 Typical High $1,023.29 | Professional | None | $234.42 | $363.08 | $1,023.29 |
Moda Health Setting Facility Modifier None Typical Low $338.84 Median $1,174.90 Typical High $2,570.40 | Facility | None | $338.84 | $1,174.90 | $2,570.40 |
Moda Health Setting Professional Modifier None Typical Low $346.74 Median $1,174.90 Typical High $1,778.28 | Professional | None | $346.74 | $1,174.90 | $1,778.28 |
Premera BCBS Setting Facility Modifier None Typical Low $416.87 Median $602.56 Typical High $794.33 | Facility | None | $416.87 | $602.56 | $794.33 |
Premera BCBS Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,445.44 | Professional | None | $912.01 | $912.01 | $1,445.44 |
Providence Setting Facility Modifier None Typical Low $549.54 Median $1,122.02 Typical High $2,041.74 | Facility | None | $549.54 | $1,122.02 | $2,041.74 |
Providence Setting Professional Modifier None Typical Low $213.80 Median $489.78 Typical High $1,023.29 | Professional | None | $213.80 | $489.78 | $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 $234.42 Median $588.84 Typical High $1,621.81 | Professional | None | $234.42 | $588.84 | $1,621.81 |
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 $114.82 Median $588.84 Typical High $891.25 | Professional | 52 · Reduced service | $114.82 | $588.84 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $234.42 Typical High $354.81 | Professional | 53 · Discontinued | $45.71 | $234.42 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $870.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $169.82 | $870.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $173.78 Typical High $269.15 | Professional | 55 · Aftercare only | $33.88 | $173.78 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $117.49 Typical High $177.83 | Professional | 56 · Pre-op care only | $22.91 | $117.49 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $812.83 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $158.49 | $812.83 | $1,258.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $588.84 Typical High $891.25 | Professional | 52 · Reduced service | $141.25 | $588.84 | $891.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $234.42 Typical High $354.81 | Professional | 53 · Discontinued | $56.23 | $234.42 | $354.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $870.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $213.80 | $870.96 | $1,348.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $173.78 Typical High $269.15 | Professional | 55 · Aftercare only | $42.66 | $173.78 | $269.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $117.49 Typical High $177.83 | Professional | 56 · Pre-op care only | $28.18 | $117.49 | $177.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $812.83 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $199.53 | $812.83 | $1,258.93 |
Where Alaska sits
The same service costs 3.6 times more in Alaska than in New Jersey. 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
$912
AK $912NJ $251
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.