How much rates vary
Facilitymedian $7,079 · 10th to 90th $4,169 to $16,596Professionalmedian $2,754 · 10th to 90th $813 to $4,365
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 $812.83 Median $4,365.16 Typical High $4,365.16 | Professional | None | $812.83 | $4,365.16 | $4,365.16 |
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 $794.33 Median $1,047.13 Typical High $2,511.89 | Professional | None | $794.33 | $1,047.13 | $2,511.89 |
Moda Health Setting Facility Modifier None Typical Low $1,230.27 Median $4,365.16 Typical High $6,165.95 | Facility | None | $1,230.27 | $4,365.16 | $6,165.95 |
Moda Health Setting Professional Modifier None Typical Low $831.76 Median $3,162.28 Typical High $4,570.88 | Professional | None | $831.76 | $3,162.28 | $4,570.88 |
Premera BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $6,456.54 Typical High $8,709.64 | Facility | None | $4,570.88 | $6,456.54 | $8,709.64 |
Premera BCBS Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
Providence Setting Facility Modifier None Typical Low $4,168.69 Median $7,413.10 Typical High $23,988.33 | Facility | None | $4,168.69 | $7,413.10 | $23,988.33 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $1,202.26 Typical High $2,511.89 | Professional | None | $60.26 | $1,202.26 | $2,511.89 |
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 $776.25 Median $2,187.76 Typical High $5,128.61 | Professional | None | $776.25 | $2,187.76 | $5,128.61 |
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 $398.11 Median $2,187.76 Typical High $2,187.76 | Professional | 52 · Reduced service | $398.11 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $870.96 Typical High $870.96 | Professional | 53 · Discontinued | $162.18 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $3,235.94 Typical High $3,235.94 | Professional | 54 · Surgery only | $602.56 | $3,235.94 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $645.65 Typical High $645.65 | Professional | 55 · Aftercare only | $120.23 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $436.52 Typical High $436.52 | Professional | 56 · Pre-op care only | $81.28 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $3,019.95 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $562.34 | $3,019.95 | $3,019.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $2,187.76 Typical High $2,187.76 | Professional | 52 · Reduced service | $416.87 | $2,187.76 | $2,187.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $870.96 Typical High $870.96 | Professional | 53 · Discontinued | $169.82 | $870.96 | $870.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $3,235.94 Typical High $3,235.94 | Professional | 54 · Surgery only | $630.96 | $3,235.94 | $3,235.94 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $645.65 Typical High $645.65 | Professional | 55 · Aftercare only | $125.89 | $645.65 | $645.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $436.52 Typical High $436.52 | Professional | 56 · Pre-op care only | $83.18 | $436.52 | $436.52 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $3,019.95 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $588.84 | $3,019.95 | $3,019.95 |
Where Alaska sits
The same service costs 6.5 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
$3,311
AK $3,311TX $513
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.