How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,000 to $251,189Professionalmedian $4,266 · 10th to 90th $1,175 to $6,310
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 $6,309.57 Median $12,022.64 Typical High $16,595.87 | Facility | None | $6,309.57 | $12,022.64 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $6,309.57 Typical High $6,309.57 | Professional | None | $1,174.90 | $6,309.57 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,659.59 Typical High $3,630.78 | Professional | None | $1,047.13 | $1,659.59 | $3,630.78 |
Moda Health Setting Facility Modifier None Typical Low $1,905.46 Median $6,309.57 Typical High $9,120.11 | Facility | None | $1,905.46 | $6,309.57 | $9,120.11 |
Moda Health Setting Professional Modifier None Typical Low $1,202.26 Median $4,897.79 Typical High $7,244.36 | Professional | None | $1,202.26 | $4,897.79 | $7,244.36 |
Premera BCBS Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
Providence Setting Facility Modifier None Typical Low $6,456.54 Median $251,188.64 Typical High $346,736.85 | Facility | None | $6,456.54 | $251,188.64 | $346,736.85 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $1,737.80 Typical High $3,630.78 | Professional | None | $60.26 | $1,737.80 | $3,630.78 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,071.52 Typical High $4,265.80 | Facility | None | $691.83 | $1,071.52 | $4,265.80 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $3,235.94 Typical High $7,413.10 | Professional | None | $1,148.15 | $3,235.94 | $7,413.10 |
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 $588.84 Median $3,162.28 Typical High $3,162.28 | Professional | 52 · Reduced service | $588.84 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $1,288.25 Typical High $1,288.25 | Professional | 53 · Discontinued | $234.42 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $4,786.30 Typical High $4,786.30 | Professional | 54 · Surgery only | $891.25 | $4,786.30 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $954.99 Typical High $954.99 | Professional | 55 · Aftercare only | $177.83 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $630.96 Typical High $630.96 | Professional | 56 · Pre-op care only | $117.49 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $4,466.84 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $831.76 | $4,466.84 | $4,466.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $3,162.28 Typical High $3,162.28 | Professional | 52 · Reduced service | $645.65 | $3,162.28 | $3,162.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $1,288.25 Typical High $1,288.25 | Professional | 53 · Discontinued | $263.03 | $1,288.25 | $1,288.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $4,786.30 Typical High $4,786.30 | Professional | 54 · Surgery only | $977.24 | $4,786.30 | $4,786.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $954.99 Typical High $954.99 | Professional | 55 · Aftercare only | $194.98 | $954.99 | $954.99 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $630.96 Typical High $630.96 | Professional | 56 · Pre-op care only | $128.82 | $630.96 | $630.96 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $4,466.84 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $912.01 | $4,466.84 | $4,466.84 |
Where Alaska sits
The same service costs 5.9 times more in Alabama than in Maryland. 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
AL $10,682MD $1,821
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.