How much rates vary
Facilitymedian $12,023 · 10th to 90th $1,000 to $251,189Professionalmedian $15,136 · 10th to 90th $4,365 to $23,988
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 $9,772.37 Median $14,125.38 Typical High $23,988.33 | Facility | None | $9,772.37 | $14,125.38 | $23,988.33 |
Aetna Setting Professional Modifier None Typical Low $4,365.16 Median $23,988.33 Typical High $23,988.33 | Professional | None | $4,365.16 | $23,988.33 | $23,988.33 |
Cigna Setting Professional Modifier None Typical Low $3,630.78 Median $6,025.60 Typical High $13,182.57 | Professional | None | $3,630.78 | $6,025.60 | $13,182.57 |
Moda Health Setting Facility Modifier None Typical Low $7,079.46 Median $23,988.33 Typical High $33,884.42 | Facility | None | $7,079.46 | $23,988.33 | $33,884.42 |
Moda Health Setting Professional Modifier None Typical Low $4,786.30 Median $18,620.87 Typical High $26,302.68 | Professional | None | $4,786.30 | $18,620.87 | $26,302.68 |
Premera BCBS Setting Professional Modifier None Typical Low $17,782.79 Median $17,782.79 Typical High $17,782.79 | Professional | None | $17,782.79 | $17,782.79 | $17,782.79 |
Providence Setting Facility Modifier None Typical Low $23,988.33 Median $251,188.64 Typical High $346,736.85 | Facility | None | $23,988.33 | $251,188.64 | $346,736.85 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $6,165.95 Typical High $13,182.57 | Professional | None | $60.26 | $6,165.95 | $13,182.57 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,071.52 Typical High $4,265.80 | Facility | None | $691.83 | $1,071.52 | $4,265.80 |
United Setting Professional Modifier None Typical Low $4,168.69 Median $12,302.69 Typical High $28,183.83 | Professional | None | $4,168.69 | $12,302.69 | $28,183.83 |
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 $2,187.76 Median $11,748.98 Typical High $11,748.98 | Professional | 52 · Reduced service | $2,187.76 | $11,748.98 | $11,748.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $870.96 Median $4,786.30 Typical High $4,786.30 | Professional | 53 · Discontinued | $870.96 | $4,786.30 | $4,786.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,311.31 Median $17,782.79 Typical High $17,782.79 | Professional | 54 · Surgery only | $3,311.31 | $17,782.79 | $17,782.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $3,548.13 Typical High $3,548.13 | Professional | 55 · Aftercare only | $660.69 | $3,548.13 | $3,548.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $436.52 Median $2,398.83 Typical High $2,398.83 | Professional | 56 · Pre-op care only | $436.52 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,090.30 Median $16,595.87 Typical High $16,595.87 | Professional | 78 · Unplanned return to OR | $3,090.30 | $16,595.87 | $16,595.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,398.83 Median $11,748.98 Typical High $11,748.98 | Professional | 52 · Reduced service | $2,398.83 | $11,748.98 | $11,748.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $954.99 Median $4,786.30 Typical High $4,786.30 | Professional | 53 · Discontinued | $954.99 | $4,786.30 | $4,786.30 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $3,630.78 Median $17,782.79 Typical High $17,782.79 | Professional | 54 · Surgery only | $3,630.78 | $17,782.79 | $17,782.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $724.44 Median $3,548.13 Typical High $3,548.13 | Professional | 55 · Aftercare only | $724.44 | $3,548.13 | $3,548.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $478.63 Median $2,398.83 Typical High $2,398.83 | Professional | 56 · Pre-op care only | $478.63 | $2,398.83 | $2,398.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,388.44 Median $16,595.87 Typical High $16,595.87 | Professional | 78 · Unplanned return to OR | $3,388.44 | $16,595.87 | $16,595.87 |
Where Alaska sits
The same service costs 21.9 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
$15,136
AK $15,136TX $692
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.