How much rates vary
Facilitymedian $7,244 · 10th to 90th $4,571 to $19,498Professionalmedian $3,631 · 10th to 90th $1,175 to $6,457
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 $14,125.38 Typical High $22,387.21 | Facility | None | $2,344.23 | $14,125.38 | $22,387.21 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $6,456.54 Typical High $6,456.54 | Professional | None | $1,174.90 | $6,456.54 | $6,456.54 |
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 $1,148.15 Median $1,513.56 Typical High $3,630.78 | Professional | None | $1,148.15 | $1,513.56 | $3,630.78 |
Moda Health Setting Facility Modifier None Typical Low $1,778.28 Median $6,456.54 Typical High $28,840.32 | Facility | None | $1,778.28 | $6,456.54 | $28,840.32 |
Moda Health Setting Professional Modifier None Typical Low $1,230.27 Median $3,630.78 Typical High $6,456.54 | Professional | None | $1,230.27 | $3,630.78 | $6,456.54 |
Premera BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $6,456.54 Typical High $8,709.64 | Facility | None | $4,570.88 | $6,456.54 | $8,709.64 |
Premera BCBS Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
Providence 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 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $1,698.24 Typical High $3,630.78 | Professional | None | $60.26 | $1,698.24 | $3,630.78 |
United Setting Facility Modifier None Typical Low $3,388.44 Median $7,585.78 Typical High $19,498.45 | Facility | None | $3,388.44 | $7,585.78 | $19,498.45 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $3,162.28 Typical High $7,244.36 | Professional | None | $1,096.48 | $3,162.28 | $7,244.36 |
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 $588.84 Median $3,235.94 Typical High $3,235.94 | Professional | 52 · Reduced service | $588.84 | $3,235.94 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $1,288.25 Typical High $1,288.25 | Professional | 53 · Discontinued | $234.42 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $4,786.30 Typical High $4,786.30 | Professional | 54 · Surgery only | $870.96 | $4,786.30 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $954.99 Typical High $954.99 | Professional | 55 · Aftercare only | $173.78 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $645.65 Typical High $645.65 | Professional | 56 · Pre-op care only | $117.49 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $4,466.84 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $812.83 | $4,466.84 | $4,466.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $3,235.94 Typical High $3,235.94 | Professional | 52 · Reduced service | $616.60 | $3,235.94 | $3,235.94 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $1,288.25 Typical High $1,288.25 | Professional | 53 · Discontinued | $245.47 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $4,786.30 Typical High $4,786.30 | Professional | 54 · Surgery only | $912.01 | $4,786.30 | $4,786.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $954.99 Typical High $954.99 | Professional | 55 · Aftercare only | $181.97 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $645.65 Typical High $645.65 | Professional | 56 · Pre-op care only | $123.03 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $4,466.84 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $851.14 | $4,466.84 | $4,466.84 |
Where Alaska sits
The same service costs 3.0 times more in Oklahoma than in Montana. 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.
Physician feeFacility fee
OK $10,899MT $3,640
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.