How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,950 to $9,772Professionalmedian $1,380 · 10th to 90th $407 to $2,399
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 $2,089.30 Median $5,888.44 Typical High $14,125.38 | Facility | None | $2,089.30 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $2,089.30 Typical High $2,398.83 | Professional | None | $389.05 | $2,089.30 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $2,290.87 Median $3,801.89 Typical High $11,748.98 | Facility | None | $2,290.87 | $3,801.89 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $1,318.26 | Professional | None | $389.05 | $537.03 | $1,318.26 |
Moda Health Setting Facility Modifier None Typical Low $575.44 Median $2,089.30 Typical High $3,388.44 | Facility | None | $575.44 | $2,089.30 | $3,388.44 |
Moda Health Setting Professional Modifier None Typical Low $436.52 Median $1,513.56 Typical High $2,398.83 | Professional | None | $436.52 | $1,513.56 | $2,398.83 |
Premera BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $2,951.21 Typical High $3,388.44 | Facility | None | $1,949.84 | $2,951.21 | $3,388.44 |
Premera BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,548.82 | $1,548.82 | $1,819.70 |
Providence Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $10,964.78 | Facility | None | $2,290.87 | $3,630.78 | $10,964.78 |
Providence Setting Professional Modifier None Typical Low $371.54 Median $660.69 Typical High $1,318.26 | Professional | None | $371.54 | $660.69 | $1,318.26 |
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 $371.54 Median $1,047.13 Typical High $2,754.23 | Professional | None | $371.54 | $1,047.13 | $2,754.23 |
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 $194.98 Median $1,047.13 Typical High $1,174.90 | Professional | 52 · Reduced service | $194.98 | $1,047.13 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $416.87 Typical High $478.63 | Professional | 53 · Discontinued | $77.62 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $1,548.82 Typical High $1,778.28 | Professional | 54 · Surgery only | $295.12 | $1,548.82 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $309.03 Typical High $354.81 | Professional | 55 · Aftercare only | $58.88 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $208.93 Typical High $239.88 | Professional | 56 · Pre-op care only | $38.90 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $1,445.44 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $275.42 | $1,445.44 | $1,659.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $1,047.13 Typical High $1,174.90 | Professional | 52 · Reduced service | $218.78 | $1,047.13 | $1,174.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $416.87 Typical High $478.63 | Professional | 53 · Discontinued | $87.10 | $416.87 | $478.63 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $1,548.82 Typical High $1,778.28 | Professional | 54 · Surgery only | $331.13 | $1,548.82 | $1,778.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $309.03 Typical High $354.81 | Professional | 55 · Aftercare only | $66.07 | $309.03 | $354.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $208.93 Typical High $239.88 | Professional | 56 · Pre-op care only | $43.65 | $208.93 | $239.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $1,445.44 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $309.03 | $1,445.44 | $1,659.59 |
Where Alaska sits
The same service costs 4.5 times more in Colorado than in Delaware. 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
CO $4,927DE $1,097
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.