How much rates vary
Facilitymedian $3,090 · 10th to 90th $708 to $9,550Professionalmedian $955 · 10th to 90th $275 to $1,738
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 $1,737.80 Median $9,549.93 Typical High $16,595.87 | Facility | None | $1,737.80 | $9,549.93 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $1,737.80 Typical High $1,737.80 | Professional | None | $251.19 | $1,737.80 | $1,737.80 |
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 $223.87 Median $371.54 Typical High $1,047.13 | Professional | None | $223.87 | $371.54 | $1,047.13 |
Moda Health Setting Facility Modifier None Typical Low $562.34 Median $1,737.80 Typical High $4,168.69 | Facility | None | $562.34 | $1,737.80 | $4,168.69 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $1,230.27 Typical High $2,137.96 | Professional | None | $309.03 | $1,230.27 | $2,137.96 |
Premera BCBS Setting Facility Modifier None Typical Low $549.54 Median $2,238.72 Typical High $3,467.37 | Facility | None | $549.54 | $2,238.72 | $3,467.37 |
Premera BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Providence Setting Facility Modifier None Typical Low $1,905.46 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,905.46 | $3,548.13 | $11,220.18 |
Providence Setting Professional Modifier None Typical Low $181.97 Median $426.58 Typical High $1,047.13 | Professional | None | $181.97 | $426.58 | $1,047.13 |
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 $302.00 Median $851.14 Typical High $1,737.80 | Professional | None | $302.00 | $851.14 | $1,737.80 |
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 $158.49 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $158.49 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $63.10 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $239.88 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $47.86 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $31.62 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $223.87 | $1,230.27 | $1,230.27 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $173.78 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $69.18 | $346.74 | $346.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $257.04 | $1,318.26 | $1,318.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $52.48 | $263.03 | $263.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $34.67 | $173.78 | $173.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $239.88 | $1,230.27 | $1,230.27 |
Where Alaska sits
The same service costs 5.5 times more in Colorado than in Michigan. 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 $4,792MI $877
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.