How much rates vary
Facilitymedian $479 · 10th to 90th $257 to $4,677Professionalmedian $437 · 10th to 90th $135 to $912
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 $588.84 Median $5,888.44 Typical High $14,125.38 | Facility | None | $588.84 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $588.84 Typical High $912.01 | Professional | None | $112.20 | $588.84 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $323.59 Typical High $1,000.00 | Facility | None | $194.98 | $323.59 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $512.86 | Professional | None | $112.20 | $186.21 | $512.86 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $588.84 Typical High $1,288.25 | Facility | None | $165.96 | $588.84 | $1,288.25 |
Moda Health Setting Professional Modifier None Typical Low $173.78 Median $588.84 Typical High $912.01 | Professional | None | $173.78 | $588.84 | $912.01 |
Premera BCBS Setting Facility Modifier None Typical Low $218.78 Median $331.13 Typical High $478.63 | Facility | None | $218.78 | $331.13 | $478.63 |
Premera BCBS Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $707.95 | Professional | None | $436.52 | $436.52 | $707.95 |
Providence Setting Facility Modifier None Typical Low $269.15 Median $562.34 Typical High $1,000.00 | Facility | None | $269.15 | $562.34 | $1,000.00 |
Providence Setting Professional Modifier None Typical Low $107.15 Median $239.88 Typical High $512.86 | Professional | None | $107.15 | $239.88 | $512.86 |
United Setting Facility Modifier None Typical Low $478.63 Median $954.99 Typical High $1,174.90 | Facility | None | $478.63 | $954.99 | $1,174.90 |
United Setting Professional Modifier None Typical Low $112.20 Median $288.40 Typical High $812.83 | Professional | None | $112.20 | $288.40 | $812.83 |
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 $54.95 Median $288.40 Typical High $457.09 | Professional | 52 · Reduced service | $54.95 | $288.40 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $117.49 Typical High $181.97 | Professional | 53 · Discontinued | $21.88 | $117.49 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $436.52 Typical High $676.08 | Professional | 54 · Surgery only | $83.18 | $436.52 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $87.10 Typical High $134.90 | Professional | 55 · Aftercare only | $16.60 | $87.10 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $58.88 Typical High $91.20 | Professional | 56 · Pre-op care only | $10.96 | $58.88 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $407.38 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $77.62 | $407.38 | $630.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $288.40 Typical High $457.09 | Professional | 52 · Reduced service | $69.18 | $288.40 | $457.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $117.49 Typical High $181.97 | Professional | 53 · Discontinued | $27.54 | $117.49 | $181.97 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $436.52 Typical High $676.08 | Professional | 54 · Surgery only | $104.71 | $436.52 | $676.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $87.10 Typical High $134.90 | Professional | 55 · Aftercare only | $20.89 | $87.10 | $134.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $58.88 Typical High $91.20 | Professional | 56 · Pre-op care only | $13.80 | $58.88 | $91.20 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $407.38 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $97.72 | $407.38 | $630.96 |
Where Alaska sits
The same service costs 3.5 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 $126
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.