How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,950 to $11,749Professionalmedian $1,698 · 10th to 90th $501 to $2,692
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 $2,691.53 Median $10,964.78 Typical High $16,595.87 | Facility | None | $2,691.53 | $10,964.78 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $2,691.53 Typical High $2,818.38 | Professional | None | $501.19 | $2,691.53 | $2,818.38 |
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 $489.78 Median $630.96 Typical High $1,548.82 | Professional | None | $489.78 | $630.96 | $1,548.82 |
Moda Health Setting Facility Modifier None Typical Low $758.58 Median $2,691.53 Typical High $3,890.45 | Facility | None | $758.58 | $2,691.53 | $3,890.45 |
Moda Health Setting Professional Modifier None Typical Low $524.81 Median $1,949.84 Typical High $2,818.38 | Professional | None | $524.81 | $1,949.84 | $2,818.38 |
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 $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Providence Setting Facility Modifier None Typical Low $2,290.87 Median $3,715.35 Typical High $11,748.98 | Facility | None | $2,290.87 | $3,715.35 | $11,748.98 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $741.31 Typical High $1,548.82 | Professional | None | $60.26 | $741.31 | $1,548.82 |
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 $478.63 Median $1,348.96 Typical High $3,090.30 | Professional | None | $478.63 | $1,348.96 | $3,090.30 |
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 $251.19 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $251.19 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $100.00 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $380.19 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $75.86 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $50.12 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $354.81 | $1,905.46 | $1,905.46 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $263.03 | $1,348.96 | $1,348.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $104.71 | $537.03 | $537.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $389.05 | $2,041.74 | $2,041.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $77.62 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $52.48 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $363.08 | $1,905.46 | $1,905.46 |
Where Alaska sits
The same service costs 3.9 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 $5,057DE $1,284
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.