How much rates vary
Facilitymedian $813 · 10th to 90th $245 to $6,607Professionalmedian $490 · 10th to 90th $158 to $851
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 $851.14 Median $6,606.93 Typical High $16,595.87 | Facility | None | $851.14 | $6,606.93 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $851.14 Typical High $851.14 | Professional | None | $158.49 | $851.14 | $851.14 |
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 $158.49 Median $208.93 Typical High $489.78 | Professional | None | $158.49 | $208.93 | $489.78 |
Moda Health Setting Facility Modifier None Typical Low $245.47 Median $851.14 Typical High $4,786.30 | Facility | None | $245.47 | $851.14 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $162.18 Median $489.78 Typical High $912.01 | Professional | None | $162.18 | $489.78 | $912.01 |
Premera BCBS Setting Facility Modifier None Typical Low $169.82 Median $602.56 Typical High $831.76 | Facility | None | $169.82 | $602.56 | $831.76 |
Premera BCBS Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Providence Setting Facility Modifier None Typical Low $457.09 Median $831.76 Typical High $2,344.23 | Facility | None | $457.09 | $831.76 | $2,344.23 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $234.42 Typical High $489.78 | Professional | None | $60.26 | $234.42 | $489.78 |
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 $151.36 Median $436.52 Typical High $1,023.29 | Professional | None | $151.36 | $436.52 | $1,023.29 |
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 $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $79.43 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $31.62 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $120.23 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $23.99 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $15.85 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $112.20 | $602.56 | $602.56 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $81.28 | $426.58 | $426.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $33.11 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $123.03 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $24.55 | $128.82 | $128.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $16.22 | $85.11 | $85.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $114.82 | $602.56 | $602.56 |
Where Alaska sits
The same service costs 6.2 times more in New York than in Florida. 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
NY $2,729FL $440
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.