How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,905 to $14,125Professionalmedian $1,318 · 10th to 90th $389 to $2,344
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 $1,737.80 Median $7,079.46 Typical High $14,125.38 | Facility | None | $1,737.80 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $1,737.80 Typical High $2,344.23 | Professional | None | $331.13 | $1,737.80 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $7,762.47 Typical High $23,988.33 | Facility | None | $4,677.35 | $7,762.47 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $512.86 Typical High $1,288.25 | Professional | None | $346.74 | $512.86 | $1,288.25 |
Moda Health Setting Facility Modifier None Typical Low $512.86 Median $1,737.80 Typical High $3,311.31 | Facility | None | $512.86 | $1,737.80 | $3,311.31 |
Moda Health Setting Professional Modifier None Typical Low $446.68 Median $1,479.11 Typical High $2,344.23 | Professional | None | $446.68 | $1,479.11 | $2,344.23 |
Premera BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $6,456.54 Typical High $8,709.64 | Facility | None | $4,168.69 | $6,456.54 | $8,709.64 |
Premera BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,318.26 | $1,819.70 |
Providence Setting Facility Modifier None Typical Low $2,454.71 Median $6,456.54 Typical High $16,218.10 | Facility | None | $2,454.71 | $6,456.54 | $16,218.10 |
Providence Setting Professional Modifier None Typical Low $331.13 Median $676.08 Typical High $1,288.25 | Professional | None | $331.13 | $676.08 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $6,165.95 Typical High $8,912.51 | Facility | None | $1,905.46 | $6,165.95 | $8,912.51 |
United Setting Professional Modifier None Typical Low $354.81 Median $891.25 Typical High $2,454.71 | Professional | None | $354.81 | $891.25 | $2,454.71 |
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 $165.96 Median $870.96 Typical High $1,174.90 | Professional | 52 · Reduced service | $165.96 | $870.96 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $346.74 Typical High $467.74 | Professional | 53 · Discontinued | $66.07 | $346.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $1,318.26 Typical High $1,737.80 | Professional | 54 · Surgery only | $251.19 | $1,318.26 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $263.03 Typical High $346.74 | Professional | 55 · Aftercare only | $50.12 | $263.03 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $173.78 Typical High $234.42 | Professional | 56 · Pre-op care only | $33.11 | $173.78 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $1,230.27 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $234.42 | $1,230.27 | $1,621.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $870.96 Typical High $1,174.90 | Professional | 52 · Reduced service | $208.93 | $870.96 | $1,174.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $346.74 Typical High $467.74 | Professional | 53 · Discontinued | $83.18 | $346.74 | $467.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $1,318.26 Typical High $1,737.80 | Professional | 54 · Surgery only | $309.03 | $1,318.26 | $1,737.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $263.03 Typical High $346.74 | Professional | 55 · Aftercare only | $63.10 | $263.03 | $346.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $173.78 Typical High $234.42 | Professional | 56 · Pre-op care only | $41.69 | $173.78 | $234.42 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $1,230.27 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $295.12 | $1,230.27 | $1,621.81 |
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
$1,318
AK $1,318NJ $331
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.