How much rates vary
Facilitymedian $832 · 10th to 90th $457 to $5,888Professionalmedian $741 · 10th to 90th $209 to $1,349
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 $954.99 Median $5,888.44 Typical High $14,125.38 | Facility | None | $954.99 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $954.99 Typical High $1,348.96 | Professional | None | $181.97 | $954.99 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $758.58 Typical High $2,344.23 | Facility | None | $457.09 | $758.58 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $758.58 | Professional | None | $190.55 | $275.42 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $269.15 Median $954.99 Typical High $1,905.46 | Facility | None | $269.15 | $954.99 | $1,905.46 |
Moda Health Setting Professional Modifier None Typical Low $239.88 Median $851.14 Typical High $1,348.96 | Professional | None | $239.88 | $851.14 | $1,348.96 |
Premera BCBS Setting Facility Modifier None Typical Low $426.58 Median $616.60 Typical High $831.76 | Facility | None | $426.58 | $616.60 | $831.76 |
Premera BCBS Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,071.52 | Professional | None | $741.31 | $741.31 | $1,071.52 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $977.24 Typical High $2,344.23 | Facility | None | $630.96 | $977.24 | $2,344.23 |
Providence Setting Professional Modifier None Typical Low $173.78 Median $371.54 Typical High $758.58 | Professional | None | $173.78 | $371.54 | $758.58 |
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 $181.97 Median $457.09 Typical High $1,258.93 | Professional | None | $181.97 | $457.09 | $1,258.93 |
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 $91.20 Median $467.74 Typical High $660.69 | Professional | 52 · Reduced service | $91.20 | $467.74 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $190.55 Typical High $269.15 | Professional | 53 · Discontinued | $37.15 | $190.55 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $707.95 Typical High $1,000.00 | Professional | 54 · Surgery only | $138.04 | $707.95 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $141.25 Typical High $199.53 | Professional | 55 · Aftercare only | $27.54 | $141.25 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $95.50 Typical High $134.90 | Professional | 56 · Pre-op care only | $18.20 | $95.50 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $660.69 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $128.82 | $660.69 | $933.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $467.74 Typical High $660.69 | Professional | 52 · Reduced service | $114.82 | $467.74 | $660.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $190.55 Typical High $269.15 | Professional | 53 · Discontinued | $45.71 | $190.55 | $269.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $707.95 Typical High $1,000.00 | Professional | 54 · Surgery only | $169.82 | $707.95 | $1,000.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $141.25 Typical High $199.53 | Professional | 55 · Aftercare only | $34.67 | $141.25 | $199.53 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $95.50 Typical High $134.90 | Professional | 56 · Pre-op care only | $22.91 | $95.50 | $134.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $660.69 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $158.49 | $660.69 | $933.25 |
Where Alaska sits
The same service costs 4.2 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
$741
AK $741TX $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.