How much rates vary
Facilitymedian $9,772 · 10th to 90th $3,981 to $35,481Professionalmedian $3,981 · 10th to 90th $603 to $28,184
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 $2,454.71 Median $12,022.64 Typical High $22,908.68 | Facility | None | $2,454.71 | $12,022.64 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $5,128.61 Typical High $28,183.83 | Professional | None | $446.68 | $5,128.61 | $28,183.83 |
Cigna Setting Facility Modifier None Typical Low $11,748.98 Median $19,498.45 Typical High $50,118.72 | Facility | None | $11,748.98 | $19,498.45 | $50,118.72 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $3,311.31 Typical High $12,589.25 | Professional | None | $537.03 | $3,311.31 | $12,589.25 |
Moda Health Setting Facility Modifier None Typical Low $724.44 Median $3,548.13 Typical High $40,738.03 | Facility | None | $724.44 | $3,548.13 | $40,738.03 |
Moda Health Setting Professional Modifier None Typical Low $1,148.15 Median $3,162.28 Typical High $28,183.83 | Professional | None | $1,148.15 | $3,162.28 | $28,183.83 |
Premera BCBS Setting Facility Modifier None Typical Low $6,456.54 Median $9,120.11 Typical High $16,218.10 | Facility | None | $6,456.54 | $9,120.11 | $16,218.10 |
Premera BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $23,442.29 | Professional | None | $1,778.28 | $1,778.28 | $23,442.29 |
Providence Setting Facility Modifier None Typical Low $3,467.37 Median $19,498.45 Typical High $41,686.94 | Facility | None | $3,467.37 | $19,498.45 | $41,686.94 |
Providence Setting Professional Modifier None Typical Low $436.52 Median $1,584.89 Typical High $16,595.87 | Professional | None | $436.52 | $1,584.89 | $16,595.87 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $9,772.37 Typical High $24,547.09 | Facility | None | $4,265.80 | $9,772.37 | $24,547.09 |
United Setting Professional Modifier None Typical Low $457.09 Median $4,570.88 Typical High $15,848.93 | Professional | None | $457.09 | $4,570.88 | $15,848.93 |
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 $223.87 Median $1,949.84 Typical High $14,125.38 | Professional | 52 · Reduced service | $223.87 | $1,949.84 | $14,125.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $776.25 Typical High $5,623.41 | Professional | 53 · Discontinued | $89.13 | $776.25 | $5,623.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $2,951.21 Typical High $21,379.62 | Professional | 54 · Surgery only | $338.84 | $2,951.21 | $21,379.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $588.84 Typical High $4,265.80 | Professional | 55 · Aftercare only | $67.61 | $588.84 | $4,265.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $389.05 Typical High $2,818.38 | Professional | 56 · Pre-op care only | $44.67 | $389.05 | $2,818.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $2,754.23 Typical High $19,952.62 | Professional | 78 · Unplanned return to OR | $316.23 | $2,754.23 | $19,952.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $1,949.84 Typical High $14,125.38 | Professional | 52 · Reduced service | $288.40 | $1,949.84 | $14,125.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $776.25 Typical High $5,623.41 | Professional | 53 · Discontinued | $114.82 | $776.25 | $5,623.41 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $2,951.21 Typical High $21,379.62 | Professional | 54 · Surgery only | $426.58 | $2,951.21 | $21,379.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $588.84 Typical High $4,265.80 | Professional | 55 · Aftercare only | $85.11 | $588.84 | $4,265.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $389.05 Typical High $2,818.38 | Professional | 56 · Pre-op care only | $57.54 | $389.05 | $2,818.38 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $2,754.23 Typical High $19,952.62 | Professional | 78 · Unplanned return to OR | $398.11 | $2,754.23 | $19,952.62 |
Where Alaska sits
The same service costs 4.1 times more in Iowa 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
IA $18,453DE $4,539
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.