How much rates vary
Facilitymedian $3,388 · 10th to 90th $977 to $9,772Professionalmedian $589 · 10th to 90th $166 to $2,188
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 $676.08 Median $5,888.44 Typical High $14,125.38 | Facility | None | $676.08 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $676.08 Typical High $2,187.76 | Professional | None | $131.83 | $676.08 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $2,238.72 Median $3,630.78 Typical High $11,220.18 | Facility | None | $2,238.72 | $3,630.78 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $398.11 Typical High $977.24 | Professional | None | $138.04 | $398.11 | $977.24 |
Moda Health Setting Facility Modifier None Typical Low $204.17 Median $691.83 Typical High $3,090.30 | Facility | None | $204.17 | $691.83 | $3,090.30 |
Moda Health Setting Professional Modifier None Typical Low $302.00 Median $676.08 Typical High $2,187.76 | Professional | None | $302.00 | $676.08 | $2,187.76 |
Premera BCBS Setting Facility Modifier None Typical Low $2,290.87 Median $3,090.30 Typical High $3,890.45 | Facility | None | $2,290.87 | $3,090.30 | $3,890.45 |
Premera BCBS Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,778.28 | Professional | None | $524.81 | $524.81 | $1,778.28 |
Providence Setting Facility Modifier None Typical Low $977.24 Median $3,388.44 Typical High $10,964.78 | Facility | None | $977.24 | $3,388.44 | $10,964.78 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $398.11 Typical High $1,174.90 | Professional | None | $125.89 | $398.11 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $6,165.95 Typical High $8,912.51 | Facility | None | $1,905.46 | $6,165.95 | $8,912.51 |
United Setting Professional Modifier None Typical Low $131.83 Median $407.38 Typical High $1,148.15 | Professional | None | $131.83 | $407.38 | $1,148.15 |
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 $66.07 Median $338.84 Typical High $1,096.48 | Professional | 52 · Reduced service | $66.07 | $338.84 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $138.04 Typical High $436.52 | Professional | 53 · Discontinued | $26.30 | $138.04 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $512.86 Typical High $1,621.81 | Professional | 54 · Surgery only | $100.00 | $512.86 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $102.33 Typical High $323.59 | Professional | 55 · Aftercare only | $19.95 | $102.33 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $67.61 Typical High $218.78 | Professional | 56 · Pre-op care only | $13.18 | $67.61 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $478.63 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $93.33 | $478.63 | $1,513.56 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $338.84 Typical High $1,096.48 | Professional | 52 · Reduced service | $81.28 | $338.84 | $1,096.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $138.04 Typical High $436.52 | Professional | 53 · Discontinued | $33.11 | $138.04 | $436.52 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $512.86 Typical High $1,621.81 | Professional | 54 · Surgery only | $123.03 | $512.86 | $1,621.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $102.33 Typical High $323.59 | Professional | 55 · Aftercare only | $24.55 | $102.33 | $323.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $67.61 Typical High $218.78 | Professional | 56 · Pre-op care only | $16.60 | $67.61 | $218.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $478.63 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $114.82 | $478.63 | $1,513.56 |
Where Alaska sits
The same service costs 5.6 times more in Colorado than in North Dakota. 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 $4,763ND $853
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.