How much rates vary
Facilitymedian $4,898 · 10th to 90th $2,344 to $12,023Professionalmedian $3,236 · 10th to 90th $955 to $5,012
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 $20,417.38 | Facility | None | $2,344.23 | $10,000.00 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $5,011.87 Typical High $5,011.87 | Professional | None | $933.25 | $5,011.87 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $2,290.87 Median $3,801.89 Typical High $11,748.98 | Facility | None | $2,290.87 | $3,801.89 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $2,951.21 | Professional | None | $851.14 | $1,230.27 | $2,951.21 |
Moda Health Setting Facility Modifier None Typical Low $1,445.44 Median $5,011.87 Typical High $7,244.36 | Facility | None | $1,445.44 | $5,011.87 | $7,244.36 |
Moda Health Setting Professional Modifier None Typical Low $1,000.00 Median $3,801.89 Typical High $5,495.41 | Professional | None | $1,000.00 | $3,801.89 | $5,495.41 |
Premera BCBS Setting Facility Modifier None Typical Low $2,041.74 Median $3,162.28 Typical High $6,165.95 | Facility | None | $2,041.74 | $3,162.28 | $6,165.95 |
Premera BCBS Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
Providence Setting Facility Modifier None Typical Low $2,290.87 Median $4,897.79 Typical High $11,748.98 | Facility | None | $2,290.87 | $4,897.79 | $11,748.98 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $1,380.38 Typical High $2,951.21 | Professional | None | $60.26 | $1,380.38 | $2,951.21 |
United Setting Facility Modifier None Typical Low $3,388.44 Median $7,585.78 Typical High $19,498.45 | Facility | None | $3,388.44 | $7,585.78 | $19,498.45 |
United Setting Professional Modifier None Typical Low $912.01 Median $2,570.40 Typical High $6,025.60 | Professional | None | $912.01 | $2,570.40 | $6,025.60 |
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 $467.74 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $467.74 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $1,023.29 Typical High $1,023.29 | Professional | 53 · Discontinued | $186.21 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $3,801.89 Typical High $3,801.89 | Professional | 54 · Surgery only | $707.95 | $3,801.89 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $758.58 Typical High $758.58 | Professional | 55 · Aftercare only | $141.25 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $93.33 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $3,548.13 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $660.69 | $3,548.13 | $3,548.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $501.19 | $2,511.89 | $2,511.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $1,023.29 Typical High $1,023.29 | Professional | 53 · Discontinued | $199.53 | $1,023.29 | $1,023.29 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $3,801.89 Typical High $3,801.89 | Professional | 54 · Surgery only | $758.58 | $3,801.89 | $3,801.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $758.58 Typical High $758.58 | Professional | 55 · Aftercare only | $151.36 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $100.00 | $501.19 | $501.19 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $3,548.13 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $707.95 | $3,548.13 | $3,548.13 |
Where Alaska sits
The same service costs 6.2 times more in Alaska than in Texas. 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.
Alaska· 1st of 51
$3,802
AK $3,802TX $617
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.