How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,413 to $9,772Professionalmedian $741 · 10th to 90th $214 to $2,455
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 $954.99 Median $5,888.44 Typical High $14,125.38 | Facility | None | $954.99 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $954.99 Typical High $2,691.53 | Professional | None | $186.21 | $954.99 | $2,691.53 |
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 $190.55 Median $512.86 Typical High $1,230.27 | Professional | None | $190.55 | $512.86 | $1,230.27 |
Moda Health Setting Facility Modifier None Typical Low $288.40 Median $1,380.38 Typical High $4,677.35 | Facility | None | $288.40 | $1,380.38 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $954.99 Typical High $2,691.53 | Professional | None | $245.47 | $954.99 | $2,691.53 |
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 $741.31 Median $741.31 Typical High $2,238.72 | Professional | None | $741.31 | $741.31 | $2,238.72 |
Providence Setting Facility Modifier None Typical Low $1,412.54 Median $3,548.13 Typical High $10,964.78 | Facility | None | $1,412.54 | $3,548.13 | $10,964.78 |
Providence Setting Professional Modifier None Typical Low $173.78 Median $549.54 Typical High $1,513.56 | Professional | None | $173.78 | $549.54 | $1,513.56 |
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 $181.97 Median $524.81 Typical High $1,513.56 | Professional | None | $181.97 | $524.81 | $1,513.56 |
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 $93.33 Median $478.63 Typical High $1,348.96 | Professional | 52 · Reduced service | $93.33 | $478.63 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $190.55 Typical High $537.03 | Professional | 53 · Discontinued | $37.15 | $190.55 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $724.44 Typical High $1,995.26 | Professional | 54 · Surgery only | $138.04 | $724.44 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $144.54 Typical High $407.38 | Professional | 55 · Aftercare only | $27.54 | $144.54 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $95.50 Typical High $269.15 | Professional | 56 · Pre-op care only | $18.62 | $95.50 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $676.08 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $128.82 | $676.08 | $1,862.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $478.63 Typical High $1,348.96 | Professional | 52 · Reduced service | $114.82 | $478.63 | $1,348.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $190.55 Typical High $537.03 | Professional | 53 · Discontinued | $45.71 | $190.55 | $537.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $724.44 Typical High $1,995.26 | Professional | 54 · Surgery only | $173.78 | $724.44 | $1,995.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $144.54 Typical High $407.38 | Professional | 55 · Aftercare only | $34.67 | $144.54 | $407.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $95.50 Typical High $269.15 | Professional | 56 · Pre-op care only | $22.91 | $95.50 | $269.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $676.08 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $162.18 | $676.08 | $1,862.09 |
Where Alaska sits
The same service costs 4.4 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 $4,844ND $1,099
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.