How much rates vary
Facilitymedian $661 · 10th to 90th $355 to $5,888Professionalmedian $562 · 10th to 90th $170 to $1,202
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 $724.44 Median $5,888.44 Typical High $14,125.38 | Facility | None | $724.44 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $724.44 Typical High $1,202.26 | Professional | None | $138.04 | $724.44 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $512.86 Typical High $1,548.82 | Facility | None | $309.03 | $512.86 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $257.04 Typical High $707.95 | Professional | None | $144.54 | $257.04 | $707.95 |
Moda Health Setting Facility Modifier None Typical Low $218.78 Median $724.44 Typical High $1,737.80 | Facility | None | $218.78 | $724.44 | $1,737.80 |
Moda Health Setting Professional Modifier None Typical Low $186.21 Median $691.83 Typical High $1,288.25 | Professional | None | $186.21 | $691.83 | $1,288.25 |
Premera BCBS Setting Facility Modifier None Typical Low $323.59 Median $457.09 Typical High $562.34 | Facility | None | $323.59 | $457.09 | $562.34 |
Premera BCBS Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $977.24 | Professional | None | $562.34 | $562.34 | $977.24 |
Providence Setting Facility Modifier None Typical Low $426.58 Median $741.31 Typical High $1,995.26 | Facility | None | $426.58 | $741.31 | $1,995.26 |
Providence Setting Professional Modifier None Typical Low $131.83 Median $323.59 Typical High $707.95 | Professional | None | $131.83 | $323.59 | $707.95 |
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 $141.25 Median $363.08 Typical High $1,000.00 | Professional | None | $141.25 | $363.08 | $1,000.00 |
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 $69.18 Median $363.08 Typical High $602.56 | Professional | 52 · Reduced service | $69.18 | $363.08 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $144.54 Typical High $239.88 | Professional | 53 · Discontinued | $28.18 | $144.54 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $537.03 Typical High $891.25 | Professional | 54 · Surgery only | $104.71 | $537.03 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $109.65 Typical High $181.97 | Professional | 55 · Aftercare only | $20.89 | $109.65 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $72.44 Typical High $120.23 | Professional | 56 · Pre-op care only | $13.80 | $72.44 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $501.19 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $97.72 | $501.19 | $831.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $363.08 Typical High $602.56 | Professional | 52 · Reduced service | $87.10 | $363.08 | $602.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $144.54 Typical High $239.88 | Professional | 53 · Discontinued | $34.67 | $144.54 | $239.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $537.03 Typical High $891.25 | Professional | 54 · Surgery only | $131.83 | $537.03 | $891.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $109.65 Typical High $181.97 | Professional | 55 · Aftercare only | $26.30 | $109.65 | $181.97 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $72.44 Typical High $120.23 | Professional | 56 · Pre-op care only | $17.38 | $72.44 | $120.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $501.19 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $123.03 | $501.19 | $831.76 |
Where Alaska sits
The same service costs 3.5 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
$562
AK $562DC $162
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.