How much rates vary
Facilitymedian $7,079 · 10th to 90th $4,169 to $20,893Professionalmedian $1,820 · 10th to 90th $550 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 $2,951.21 Median $14,125.38 Typical High $20,892.96 | Facility | None | $2,951.21 | $14,125.38 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $2,951.21 Typical High $3,981.07 | Professional | None | $537.03 | $2,951.21 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $7,762.47 Typical High $23,988.33 | Facility | None | $4,677.35 | $7,762.47 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $1,698.24 | Professional | None | $501.19 | $776.25 | $1,698.24 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $4,466.84 Typical High $19,498.45 | Facility | None | $891.25 | $4,466.84 | $19,498.45 |
Moda Health Setting Professional Modifier None Typical Low $549.54 Median $1,995.26 Typical High $3,467.37 | Professional | None | $549.54 | $1,995.26 | $3,467.37 |
Premera BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $6,309.57 Typical High $8,912.51 | Facility | None | $4,466.84 | $6,309.57 | $8,912.51 |
Premera BCBS Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Providence Setting Facility Modifier None Typical Low $3,019.95 Median $7,585.78 Typical High $23,988.33 | Facility | None | $3,019.95 | $7,585.78 | $23,988.33 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $812.83 Typical High $1,698.24 | Professional | None | $60.26 | $812.83 | $1,698.24 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $11,220.18 Typical High $24,547.09 | Facility | None | $4,265.80 | $11,220.18 | $24,547.09 |
United Setting Professional Modifier None Typical Low $524.81 Median $1,479.11 Typical High $4,073.80 | Professional | None | $524.81 | $1,479.11 | $4,073.80 |
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 $275.42 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $275.42 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $109.65 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $407.38 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $81.28 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $54.95 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $380.19 | $2,089.30 | $2,089.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $302.00 | $1,479.11 | $1,479.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $120.23 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $457.09 | $2,238.72 | $2,238.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $91.20 | $446.68 | $446.68 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $60.26 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $426.58 | $2,089.30 | $2,089.30 |
Where Alaska sits
The same service costs 6.0 times more in Wisconsin 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
WI $11,096MT $1,846
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.