How much rates vary
Facilitymedian $501 · 10th to 90th $214 to $5,888Professionalmedian $427 · 10th to 90th $123 to $741
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 $575.44 Median $5,888.44 Typical High $14,125.38 | Facility | None | $575.44 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $575.44 Typical High $741.31 | Professional | None | $112.20 | $575.44 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $257.04 Typical High $794.33 | Facility | None | $154.88 | $257.04 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $436.52 | Professional | None | $114.82 | $173.78 | $436.52 |
Moda Health Setting Facility Modifier None Typical Low $169.82 Median $575.44 Typical High $1,071.52 | Facility | None | $169.82 | $575.44 | $1,071.52 |
Moda Health Setting Professional Modifier None Typical Low $134.90 Median $436.52 Typical High $741.31 | Professional | None | $134.90 | $436.52 | $741.31 |
Premera BCBS Setting Facility Modifier None Typical Low $204.17 Median $275.42 Typical High $407.38 | Facility | None | $204.17 | $275.42 | $407.38 |
Premera BCBS Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $588.84 | Professional | None | $446.68 | $446.68 | $588.84 |
Providence Setting Facility Modifier None Typical Low $213.80 Median $467.74 Typical High $1,148.15 | Facility | None | $213.80 | $467.74 | $1,148.15 |
Providence Setting Professional Modifier None Typical Low $107.15 Median $218.78 Typical High $426.58 | Professional | None | $107.15 | $218.78 | $426.58 |
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 $281.84 Typical High $776.25 | Professional | None | $112.20 | $281.84 | $776.25 |
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 $56.23 Median $288.40 Typical High $371.54 | Professional | 52 · Reduced service | $56.23 | $288.40 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $114.82 Typical High $147.91 | Professional | 53 · Discontinued | $22.39 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $426.58 Typical High $562.34 | Professional | 54 · Surgery only | $83.18 | $426.58 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $87.10 Typical High $112.20 | Professional | 55 · Aftercare only | $16.60 | $87.10 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $57.54 Typical High $74.13 | Professional | 56 · Pre-op care only | $11.22 | $57.54 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $398.11 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $77.62 | $398.11 | $524.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $288.40 Typical High $371.54 | Professional | 52 · Reduced service | $69.18 | $288.40 | $371.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $114.82 Typical High $147.91 | Professional | 53 · Discontinued | $27.54 | $114.82 | $147.91 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $426.58 Typical High $562.34 | Professional | 54 · Surgery only | $104.71 | $426.58 | $562.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $87.10 Typical High $112.20 | Professional | 55 · Aftercare only | $20.89 | $87.10 | $112.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $57.54 Typical High $74.13 | Professional | 56 · Pre-op care only | $13.80 | $57.54 | $74.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $398.11 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $97.72 | $398.11 | $524.81 |
Where Alaska sits
The same service costs 4.0 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
$437
AK $437NJ $110
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.