How much rates vary
Facilitymedian $1,622 · 10th to 90th $851 to $5,888Professionalmedian $646 · 10th to 90th $178 to $1,096
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 $812.83 Median $5,888.44 Typical High $14,125.38 | Facility | None | $812.83 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $812.83 Typical High $1,096.48 | Professional | None | $158.49 | $812.83 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $5,248.07 | Facility | None | $1,023.29 | $1,698.24 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $630.96 | Professional | None | $165.96 | $239.88 | $630.96 |
Moda Health Setting Facility Modifier None Typical Low $234.42 Median $812.83 Typical High $1,584.89 | Facility | None | $234.42 | $812.83 | $1,584.89 |
Moda Health Setting Professional Modifier None Typical Low $208.93 Median $676.08 Typical High $1,096.48 | Professional | None | $208.93 | $676.08 | $1,096.48 |
Premera BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $2,041.74 | Facility | None | $1,071.52 | $1,479.11 | $2,041.74 |
Premera BCBS Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $870.96 | Professional | None | $645.65 | $645.65 | $870.96 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $5,248.07 | Facility | None | $1,023.29 | $1,621.81 | $5,248.07 |
Providence Setting Professional Modifier None Typical Low $151.36 Median $316.23 Typical High $630.96 | Professional | None | $151.36 | $316.23 | $630.96 |
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 $158.49 Median $398.11 Typical High $1,096.48 | Professional | None | $158.49 | $398.11 | $1,096.48 |
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 $79.43 Median $407.38 Typical High $549.54 | Professional | 52 · Reduced service | $79.43 | $407.38 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $162.18 Typical High $218.78 | Professional | 53 · Discontinued | $32.36 | $162.18 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $616.60 Typical High $831.76 | Professional | 54 · Surgery only | $120.23 | $616.60 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $123.03 Typical High $165.96 | Professional | 55 · Aftercare only | $23.99 | $123.03 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $81.28 Typical High $109.65 | Professional | 56 · Pre-op care only | $15.85 | $81.28 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $575.44 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $112.20 | $575.44 | $776.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $407.38 Typical High $549.54 | Professional | 52 · Reduced service | $100.00 | $407.38 | $549.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $162.18 Typical High $218.78 | Professional | 53 · Discontinued | $39.81 | $162.18 | $218.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $616.60 Typical High $831.76 | Professional | 54 · Surgery only | $147.91 | $616.60 | $831.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $123.03 Typical High $165.96 | Professional | 55 · Aftercare only | $29.51 | $123.03 | $165.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $81.28 Typical High $109.65 | Professional | 56 · Pre-op care only | $19.95 | $81.28 | $109.65 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $575.44 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $138.04 | $575.44 | $776.25 |
Where Alaska sits
The same service costs 4.2 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
$646
AK $646NJ $155
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.