How much rates vary
Facilitymedian $2,138 · 10th to 90th $1,096 to $7,079Professionalmedian $646 · 10th to 90th $214 to $2,089
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 $5,888.44 Typical High $14,125.38 | Facility | None | $851.14 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $851.14 Typical High $2,089.30 | Professional | None | $158.49 | $851.14 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $2,290.87 Typical High $7,079.46 | Facility | None | $1,380.38 | $2,290.87 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $436.52 Typical High $1,230.27 | Professional | None | $165.96 | $436.52 | $1,230.27 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $851.14 Typical High $3,019.95 | Facility | None | $251.19 | $851.14 | $3,019.95 |
Moda Health Setting Professional Modifier None Typical Low $371.54 Median $851.14 Typical High $2,089.30 | Professional | None | $371.54 | $851.14 | $2,089.30 |
Premera BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $2,454.71 | Facility | None | $1,258.93 | $1,862.09 | $2,454.71 |
Premera BCBS Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,698.24 | Professional | None | $645.65 | $645.65 | $1,698.24 |
Providence Setting Facility Modifier None Typical Low $1,202.26 Median $2,290.87 Typical High $7,079.46 | Facility | None | $1,202.26 | $2,290.87 | $7,079.46 |
Providence Setting Professional Modifier None Typical Low $154.88 Median $446.68 Typical High $1,174.90 | Professional | None | $154.88 | $446.68 | $1,174.90 |
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 $165.96 Median $436.52 Typical High $1,318.26 | Professional | None | $165.96 | $436.52 | $1,318.26 |
10 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 $1,047.13 | Professional | 52 · Reduced service | $79.43 | $426.58 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $173.78 Typical High $416.87 | Professional | 53 · Discontinued | $31.62 | $173.78 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $645.65 Typical High $1,584.89 | Professional | 54 · Surgery only | $120.23 | $645.65 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $128.82 Typical High $316.23 | Professional | 55 · Aftercare only | $23.99 | $128.82 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $85.11 Typical High $208.93 | Professional | 56 · Pre-op care only | $15.85 | $85.11 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $426.58 Typical High $1,047.13 | Professional | 52 · Reduced service | $100.00 | $426.58 | $1,047.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $173.78 Typical High $416.87 | Professional | 53 · Discontinued | $39.81 | $173.78 | $416.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $645.65 Typical High $1,584.89 | Professional | 54 · Surgery only | $151.36 | $645.65 | $1,584.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $128.82 Typical High $316.23 | Professional | 55 · Aftercare only | $30.20 | $128.82 | $316.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $85.11 Typical High $208.93 | Professional | 56 · Pre-op care only | $19.95 | $85.11 | $208.93 |
Where Alaska sits
The same service costs 4.5 times more in Alaska than in Washington, DC. 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.
Alaska· 1st of 51
$851
AK $851DC $191
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.