How much rates vary
Facilitymedian $6,607 · 10th to 90th $2,042 to $12,882Professionalmedian $851 · 10th to 90th $282 to $1,549
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 $1,548.82 Median $10,964.78 Typical High $16,595.87 | Facility | None | $1,548.82 | $10,964.78 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $1,548.82 Typical High $1,548.82 | Professional | None | $281.84 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $7,762.47 Typical High $14,125.38 | Facility | None | $4,677.35 | $7,762.47 | $14,125.38 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $891.25 | Professional | None | $281.84 | $380.19 | $891.25 |
Moda Health Setting Facility Modifier None Typical Low $1,548.82 Median $6,309.57 Typical High $13,803.84 | Facility | None | $1,548.82 | $6,309.57 | $13,803.84 |
Moda Health Setting Professional Modifier None Typical Low $288.40 Median $851.14 Typical High $1,621.81 | Professional | None | $288.40 | $851.14 | $1,621.81 |
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 $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Providence Setting Facility Modifier None Typical Low $1,479.11 Median $7,413.10 Typical High $14,125.38 | Facility | None | $1,479.11 | $7,413.10 | $14,125.38 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $426.58 Typical High $891.25 | Professional | None | $60.26 | $426.58 | $891.25 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $6,606.93 Typical High $8,912.51 | Facility | None | $1,905.46 | $6,606.93 | $8,912.51 |
United Setting Professional Modifier None Typical Low $269.15 Median $758.58 Typical High $1,737.80 | Professional | None | $269.15 | $758.58 | $1,737.80 |
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 $144.54 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $144.54 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $57.54 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $213.80 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $42.66 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $28.84 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $199.53 | $1,096.48 | $1,096.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $147.91 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $60.26 | $309.03 | $309.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $223.87 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $44.67 | $234.42 | $234.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $30.20 | $154.88 | $154.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $208.93 | $1,096.48 | $1,096.48 |
Where Alaska sits
The same service costs 5.5 times more in Alaska than in Utah. 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
$1,202
AK $1,202UT $219
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.