How much rates vary
Facilitymedian $3,020 · 10th to 90th $891 to $9,772Professionalmedian $501 · 10th to 90th $145 to $1,072
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 $630.96 Median $5,888.44 Typical High $14,125.38 | Facility | None | $630.96 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $630.96 Typical High $1,071.52 | Professional | None | $123.03 | $630.96 | $1,071.52 |
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 $131.83 Median $218.78 Typical High $602.56 | Professional | None | $131.83 | $218.78 | $602.56 |
Moda Health Setting Facility Modifier None Typical Low $181.97 Median $912.01 Typical High $3,019.95 | Facility | None | $181.97 | $912.01 | $3,019.95 |
Moda Health Setting Professional Modifier None Typical Low $154.88 Median $562.34 Typical High $1,071.52 | Professional | None | $154.88 | $562.34 | $1,071.52 |
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 $501.19 Median $501.19 Typical High $891.25 | Professional | None | $501.19 | $501.19 | $891.25 |
Providence Setting Facility Modifier None Typical Low $891.25 Median $3,162.28 Typical High $10,964.78 | Facility | None | $891.25 | $3,162.28 | $10,964.78 |
Providence Setting Professional Modifier None Typical Low $117.49 Median $269.15 Typical High $588.84 | Professional | None | $117.49 | $269.15 | $588.84 |
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 $117.49 Median $295.12 Typical High $812.83 | Professional | None | $117.49 | $295.12 | $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 $63.10 Median $316.23 Typical High $537.03 | Professional | 52 · Reduced service | $63.10 | $316.23 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $125.89 Typical High $213.80 | Professional | 53 · Discontinued | $25.12 | $125.89 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $478.63 Typical High $794.33 | Professional | 54 · Surgery only | $93.33 | $478.63 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $95.50 Typical High $162.18 | Professional | 55 · Aftercare only | $18.62 | $95.50 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $63.10 Typical High $107.15 | Professional | 56 · Pre-op care only | $12.59 | $63.10 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $446.68 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $87.10 | $446.68 | $741.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $316.23 Typical High $537.03 | Professional | 52 · Reduced service | $77.62 | $316.23 | $537.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $125.89 Typical High $213.80 | Professional | 53 · Discontinued | $30.90 | $125.89 | $213.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $478.63 Typical High $794.33 | Professional | 54 · Surgery only | $117.49 | $478.63 | $794.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $95.50 Typical High $162.18 | Professional | 55 · Aftercare only | $23.44 | $95.50 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $63.10 Typical High $107.15 | Professional | 56 · Pre-op care only | $15.49 | $63.10 | $107.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $446.68 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $109.65 | $446.68 | $741.31 |
Where Alaska sits
The same service costs 9.8 times more in Colorado than in North Dakota. 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 $4,589ND $469
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.