How much rates vary
Facilitymedian $6,761 · 10th to 90th $3,388 to $16,596Professionalmedian $2,399 · 10th to 90th $724 to $3,802
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 $724.44 Median $3,801.89 Typical High $3,801.89 | Professional | None | $724.44 | $3,801.89 | $3,801.89 |
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 $630.96 Median $912.01 Typical High $2,290.87 | Professional | None | $630.96 | $912.01 | $2,290.87 |
Moda Health Setting Facility Modifier None Typical Low $1,122.02 Median $3,801.89 Typical High $5,495.41 | Facility | None | $1,122.02 | $3,801.89 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $758.58 Median $2,884.03 Typical High $4,365.16 | Professional | None | $758.58 | $2,884.03 | $4,365.16 |
Premera BCBS Setting Facility Modifier None Typical Low $3,090.30 Median $6,309.57 Typical High $7,244.36 | Facility | None | $3,090.30 | $6,309.57 | $7,244.36 |
Premera BCBS Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
Providence Setting Facility Modifier None Typical Low $3,801.89 Median $7,413.10 Typical High $23,988.33 | Facility | None | $3,801.89 | $7,413.10 | $23,988.33 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $1,096.48 Typical High $2,290.87 | Professional | None | $60.26 | $1,096.48 | $2,290.87 |
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 $660.69 Median $1,862.09 Typical High $4,265.80 | Professional | None | $660.69 | $1,862.09 | $4,265.80 |
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 $363.08 Median $1,905.46 Typical High $1,905.46 | Professional | 52 · Reduced service | $363.08 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $758.58 Typical High $758.58 | Professional | 53 · Discontinued | $144.54 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $2,884.03 Typical High $2,884.03 | Professional | 54 · Surgery only | $549.54 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $575.44 Typical High $575.44 | Professional | 55 · Aftercare only | $109.65 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $380.19 Typical High $380.19 | Professional | 56 · Pre-op care only | $72.44 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $2,691.53 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $512.86 | $2,691.53 | $2,691.53 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $1,905.46 Typical High $1,905.46 | Professional | 52 · Reduced service | $380.19 | $1,905.46 | $1,905.46 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $758.58 Typical High $758.58 | Professional | 53 · Discontinued | $151.36 | $758.58 | $758.58 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $2,884.03 Typical High $2,884.03 | Professional | 54 · Surgery only | $562.34 | $2,884.03 | $2,884.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $575.44 Typical High $575.44 | Professional | 55 · Aftercare only | $112.20 | $575.44 | $575.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $380.19 Typical High $380.19 | Professional | 56 · Pre-op care only | $75.86 | $380.19 | $380.19 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $2,691.53 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $524.81 | $2,691.53 | $2,691.53 |
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
$3,020
AK $3,020TX $490
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.