How much rates vary
Facilitymedian $4,467 · 10th to 90th $2,692 to $12,023Professionalmedian $2,089 · 10th to 90th $589 to $3,090
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 $2,344.23 Median $10,000.00 Typical High $16,982.44 | Facility | None | $2,344.23 | $10,000.00 | $16,982.44 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $3,090.30 Typical High $3,090.30 | Professional | None | $575.44 | $3,090.30 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $2,691.53 Median $4,466.84 Typical High $13,803.84 | Facility | None | $2,691.53 | $4,466.84 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $831.76 Typical High $1,819.70 | Professional | None | $524.81 | $831.76 | $1,819.70 |
Moda Health Setting Facility Modifier None Typical Low $933.25 Median $3,090.30 Typical High $4,466.84 | Facility | None | $933.25 | $3,090.30 | $4,466.84 |
Moda Health Setting Professional Modifier None Typical Low $630.96 Median $2,454.71 Typical High $3,548.13 | Professional | None | $630.96 | $2,454.71 | $3,548.13 |
Premera BCBS Setting Facility Modifier None Typical Low $3,019.95 Median $4,168.69 Typical High $4,897.79 | Facility | None | $3,019.95 | $4,168.69 | $4,897.79 |
Premera BCBS Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Providence Setting Facility Modifier None Typical Low $2,691.53 Median $4,466.84 Typical High $13,803.84 | Facility | None | $2,691.53 | $4,466.84 | $13,803.84 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $870.96 Typical High $1,819.70 | Professional | None | $60.26 | $870.96 | $1,819.70 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $7,079.46 Typical High $10,471.29 | Facility | None | $2,570.40 | $7,079.46 | $10,471.29 |
United Setting Professional Modifier None Typical Low $549.54 Median $1,548.82 Typical High $3,548.13 | Professional | None | $549.54 | $1,548.82 | $3,548.13 |
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 $288.40 Median $1,548.82 Typical High $1,548.82 | Professional | 52 · Reduced service | $288.40 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $114.82 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $426.58 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $85.11 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $57.54 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $398.11 | $2,187.76 | $2,187.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $1,548.82 Typical High $1,548.82 | Professional | 52 · Reduced service | $316.23 | $1,548.82 | $1,548.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $125.89 | $616.60 | $616.60 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $2,344.23 Typical High $2,344.23 | Professional | 54 · Surgery only | $478.63 | $2,344.23 | $2,344.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $467.74 Typical High $467.74 | Professional | 55 · Aftercare only | $95.50 | $467.74 | $467.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $63.10 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $2,187.76 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $446.68 | $2,187.76 | $2,187.76 |
Where Alaska sits
The same service costs 4.0 times more in Oklahoma than in Montana. 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
OK $7,771MT $1,932
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.