How much rates vary
Facilitymedian $6,457 · 10th to 90th $2,344 to $14,125Professionalmedian $2,754 · 10th to 90th $776 to $4,467
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 $2,344.23 Median $9,772.37 Typical High $16,595.87 | Facility | None | $2,344.23 | $9,772.37 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $3,548.13 Typical High $4,466.84 | Professional | None | $691.83 | $3,548.13 | $4,466.84 |
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 $660.69 Median $954.99 Typical High $2,511.89 | Professional | None | $660.69 | $954.99 | $2,511.89 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $4,466.84 Typical High $13,803.84 | Facility | None | $1,000.00 | $4,466.84 | $13,803.84 |
Moda Health Setting Professional Modifier None Typical Low $891.25 Median $3,090.30 Typical High $4,466.84 | Professional | None | $891.25 | $3,090.30 | $4,466.84 |
Premera BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $6,309.57 Typical High $7,244.36 | Facility | None | $2,951.21 | $6,309.57 | $7,244.36 |
Premera BCBS Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,548.13 | Professional | None | $2,754.23 | $2,754.23 | $3,548.13 |
Providence Setting Facility Modifier None Typical Low $4,677.35 Median $6,760.83 Typical High $23,988.33 | Facility | None | $4,677.35 | $6,760.83 | $23,988.33 |
Providence Setting Professional Modifier None Typical Low $645.65 Median $1,258.93 Typical High $2,511.89 | Professional | None | $645.65 | $1,258.93 | $2,511.89 |
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 $660.69 Median $1,778.28 Typical High $4,786.30 | Professional | None | $660.69 | $1,778.28 | $4,786.30 |
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 $346.74 Median $1,778.28 Typical High $2,238.72 | Professional | 52 · Reduced service | $346.74 | $1,778.28 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $724.44 Typical High $891.25 | Professional | 53 · Discontinued | $138.04 | $724.44 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $2,691.53 Typical High $3,388.44 | Professional | 54 · Surgery only | $512.86 | $2,691.53 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $537.03 Typical High $676.08 | Professional | 55 · Aftercare only | $102.33 | $537.03 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $354.81 Typical High $446.68 | Professional | 56 · Pre-op care only | $69.18 | $354.81 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $2,511.89 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $478.63 | $2,511.89 | $3,162.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $1,778.28 Typical High $2,238.72 | Professional | 52 · Reduced service | $416.87 | $1,778.28 | $2,238.72 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $724.44 Typical High $891.25 | Professional | 53 · Discontinued | $169.82 | $724.44 | $891.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $2,691.53 Typical High $3,388.44 | Professional | 54 · Surgery only | $630.96 | $2,691.53 | $3,388.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $537.03 Typical High $676.08 | Professional | 55 · Aftercare only | $125.89 | $537.03 | $676.08 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $354.81 Typical High $446.68 | Professional | 56 · Pre-op care only | $85.11 | $354.81 | $446.68 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $2,511.89 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $588.84 | $2,511.89 | $3,162.28 |
Where Alaska sits
The same service costs 4.4 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
$2,754
AK $2,754NJ $631
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.