How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,122 to $7,079Professionalmedian $2,455 · 10th to 90th $741 to $3,890
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 $1,949.84 Median $9,549.93 Typical High $16,595.87 | Facility | None | $1,949.84 | $9,549.93 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $3,890.45 Typical High $3,890.45 | Professional | None | $741.31 | $3,890.45 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $5,248.07 | Facility | None | $1,023.29 | $1,698.24 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $954.99 Typical High $2,344.23 | Professional | None | $630.96 | $954.99 | $2,344.23 |
Moda Health Setting Facility Modifier None Typical Low $1,122.02 Median $3,890.45 Typical High $5,623.41 | Facility | None | $1,122.02 | $3,890.45 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $776.25 Median $2,951.21 Typical High $4,365.16 | Professional | None | $776.25 | $2,951.21 | $4,365.16 |
Premera BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $3,090.30 | Facility | None | $1,148.15 | $1,548.82 | $3,090.30 |
Premera BCBS Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $2,187.76 Typical High $5,495.41 | Facility | None | $1,023.29 | $2,187.76 | $5,495.41 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $1,122.02 Typical High $2,344.23 | Professional | None | $60.26 | $1,122.02 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $3,162.28 Typical High $4,265.80 | Facility | None | $1,096.48 | $3,162.28 | $4,265.80 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,949.84 Typical High $4,570.88 | Professional | None | $691.83 | $1,949.84 | $4,570.88 |
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 $371.54 Median $1,949.84 Typical High $1,949.84 | Professional | 52 · Reduced service | $371.54 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $776.25 Typical High $776.25 | Professional | 53 · Discontinued | $147.91 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $2,951.21 Typical High $2,951.21 | Professional | 54 · Surgery only | $562.34 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $112.20 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $389.05 Typical High $389.05 | Professional | 56 · Pre-op care only | $74.13 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $2,754.23 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $524.81 | $2,754.23 | $2,754.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $1,949.84 Typical High $1,949.84 | Professional | 52 · Reduced service | $389.05 | $1,949.84 | $1,949.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $776.25 Typical High $776.25 | Professional | 53 · Discontinued | $154.88 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $2,951.21 Typical High $2,951.21 | Professional | 54 · Surgery only | $575.44 | $2,951.21 | $2,951.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $114.82 | $588.84 | $588.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $389.05 Typical High $389.05 | Professional | 56 · Pre-op care only | $77.62 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $2,754.23 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $537.03 | $2,754.23 | $2,754.23 |
Where Alaska sits
The same service costs 4.7 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
$2,399
AK $2,399TX $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.