How much rates vary
Facilitymedian $933 · 10th to 90th $457 to $2,951Professionalmedian $741 · 10th to 90th $191 to $1,514
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 $933.25 Median $9,772.37 Typical High $16,595.87 | Facility | None | $933.25 | $9,772.37 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $933.25 Typical High $1,548.82 | Professional | None | $169.82 | $933.25 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $758.58 Typical High $2,290.87 | Facility | None | $457.09 | $758.58 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $281.84 Typical High $912.01 | Professional | None | $147.91 | $281.84 | $912.01 |
Moda Health Setting Facility Modifier None Typical Low $309.03 Median $933.25 Typical High $2,238.72 | Facility | None | $309.03 | $933.25 | $2,238.72 |
Moda Health Setting Professional Modifier None Typical Low $213.80 Median $891.25 Typical High $1,548.82 | Professional | None | $213.80 | $891.25 | $1,548.82 |
Premera BCBS Setting Facility Modifier None Typical Low $407.38 Median $630.96 Typical High $851.14 | Facility | None | $407.38 | $630.96 | $851.14 |
Premera BCBS Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,258.93 | Professional | None | $741.31 | $741.31 | $1,258.93 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $1,047.13 Typical High $2,290.87 | Facility | None | $630.96 | $1,047.13 | $2,290.87 |
Providence Setting Professional Modifier None Typical Low $147.91 Median $398.11 Typical High $912.01 | Professional | None | $147.91 | $398.11 | $912.01 |
United Setting Facility Modifier None Typical Low $831.76 Median $1,778.28 Typical High $2,951.21 | Facility | None | $831.76 | $1,778.28 | $2,951.21 |
United Setting Professional Modifier None Typical Low $177.83 Median $457.09 Typical High $1,071.52 | Professional | None | $177.83 | $457.09 | $1,071.52 |
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 $91.20 Median $467.74 Typical High $776.25 | Professional | 52 · Reduced service | $91.20 | $467.74 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $186.21 Typical High $309.03 | Professional | 53 · Discontinued | $36.31 | $186.21 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $707.95 Typical High $1,148.15 | Professional | 54 · Surgery only | $138.04 | $707.95 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $141.25 Typical High $234.42 | Professional | 55 · Aftercare only | $27.54 | $141.25 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $93.33 Typical High $154.88 | Professional | 56 · Pre-op care only | $18.20 | $93.33 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $660.69 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $128.82 | $660.69 | $1,071.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $467.74 Typical High $776.25 | Professional | 52 · Reduced service | $114.82 | $467.74 | $776.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $186.21 Typical High $309.03 | Professional | 53 · Discontinued | $46.77 | $186.21 | $309.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $707.95 Typical High $1,148.15 | Professional | 54 · Surgery only | $173.78 | $707.95 | $1,148.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $141.25 Typical High $234.42 | Professional | 55 · Aftercare only | $34.67 | $141.25 | $234.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $93.33 Typical High $154.88 | Professional | 56 · Pre-op care only | $22.91 | $93.33 | $154.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $660.69 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $162.18 | $660.69 | $1,071.52 |
Where Alaska sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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
$741
AK $741KY $166
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.