How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,445 to $5,248Professionalmedian $4,786 · 10th to 90th $79 to $5,754
Distribution of negotiated rates across all payers (price axis is log-scale). 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 Professional Modifier None Typical Low $2,818.38 Median $7,079.46 Typical High $8,709.64 | Professional | None | $2,818.38 | $7,079.46 | $8,709.64 |
Cigna Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,786.30 | $4,786.30 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $3,235.94 Median $4,786.30 Typical High $5,248.07 | Professional | None | $3,235.94 | $4,786.30 | $5,248.07 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $4,365.16 Median $4,786.30 Typical High $5,495.41 | Facility | None | $4,365.16 | $4,786.30 | $5,495.41 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,090.30 Median $4,786.30 Typical High $5,128.61 | Professional | None | $3,090.30 | $4,786.30 | $5,128.61 |
Providence Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,786.30 | $4,786.30 | $4,786.30 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $4,466.84 Typical High $4,897.79 | Professional | None | $79.43 | $4,466.84 | $4,897.79 |
United Setting Facility Modifier None Typical Low $602.56 Median $954.99 Typical High $1,862.09 | Facility | None | $602.56 | $954.99 | $1,862.09 |
United Setting Professional Modifier None Typical Low $4,365.16 Median $5,128.61 Typical High $6,025.60 | Professional | None | $4,365.16 | $5,128.61 | $6,025.60 |
6 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 $1,412.54 Median $4,365.16 Typical High $4,365.16 | Professional | 52 · Reduced service | $1,412.54 | $4,365.16 | $4,365.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $1,778.28 Typical High $1,778.28 | Professional | 53 · Discontinued | $562.34 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $6,606.93 Typical High $6,606.93 | Professional | 54 · Surgery only | $2,089.30 | $6,606.93 | $6,606.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $1,318.26 Typical High $1,318.26 | Professional | 55 · Aftercare only | $426.58 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $870.96 Typical High $870.96 | Professional | 56 · Pre-op care only | $281.84 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $6,165.95 Typical High $6,165.95 | Professional | 78 · Unplanned return to OR | $1,949.84 | $6,165.95 | $6,165.95 |
Where Montana sits
The same service costs 6.5 times more in Alaska than in Delaware. 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
AK $24,325DE $3,746
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.