How much rates vary
Facilitymedian $851 · 10th to 90th $389 to $7,079Professionalmedian $646 · 10th to 90th $200 to $1,288
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 $851.14 Median $7,079.46 Typical High $14,125.38 | Facility | None | $851.14 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $851.14 Typical High $1,288.25 | Professional | None | $162.18 | $851.14 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $467.74 Typical High $1,445.44 | Facility | None | $281.84 | $467.74 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $275.42 Typical High $724.44 | Professional | None | $173.78 | $275.42 | $724.44 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $851.14 Typical High $1,862.09 | Facility | None | $251.19 | $851.14 | $1,862.09 |
Moda Health Setting Professional Modifier None Typical Low $234.42 Median $707.95 Typical High $1,288.25 | Professional | None | $234.42 | $707.95 | $1,288.25 |
Premera BCBS Setting Facility Modifier None Typical Low $380.19 Median $512.86 Typical High $794.33 | Facility | None | $380.19 | $512.86 | $794.33 |
Premera BCBS Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,023.29 | Professional | None | $645.65 | $645.65 | $1,023.29 |
Providence Setting Facility Modifier None Typical Low $389.05 Median $851.14 Typical High $1,995.26 | Facility | None | $389.05 | $851.14 | $1,995.26 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $371.54 Typical High $724.44 | Professional | None | $165.96 | $371.54 | $724.44 |
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 $173.78 Median $446.68 Typical High $1,230.27 | Professional | None | $173.78 | $446.68 | $1,230.27 |
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 $83.18 Median $426.58 Typical High $645.65 | Professional | 52 · Reduced service | $83.18 | $426.58 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $169.82 Typical High $257.04 | Professional | 53 · Discontinued | $33.11 | $169.82 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $645.65 Typical High $977.24 | Professional | 54 · Surgery only | $125.89 | $645.65 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $128.82 Typical High $194.98 | Professional | 55 · Aftercare only | $25.12 | $128.82 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $85.11 Typical High $128.82 | Professional | 56 · Pre-op care only | $16.60 | $85.11 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $602.56 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $117.49 | $602.56 | $912.01 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $426.58 Typical High $645.65 | Professional | 52 · Reduced service | $102.33 | $426.58 | $645.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $169.82 Typical High $257.04 | Professional | 53 · Discontinued | $40.74 | $169.82 | $257.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $645.65 Typical High $977.24 | Professional | 54 · Surgery only | $154.88 | $645.65 | $977.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $128.82 Typical High $194.98 | Professional | 55 · Aftercare only | $30.90 | $128.82 | $194.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $85.11 Typical High $128.82 | Professional | 56 · Pre-op care only | $20.42 | $85.11 | $128.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $602.56 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $144.54 | $602.56 | $912.01 |
Where Alaska sits
The same service costs 3.6 times more in Alaska than in Texas. 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
$646
AK $646TX $178
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.