How much rates vary
Facilitymedian $7,762 · 10th to 90th $1,000 to $251,189Professionalmedian $5,129 · 10th to 90th $1,445 to $7,762
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 $7,762.47 Median $12,022.64 Typical High $16,595.87 | Facility | None | $7,762.47 | $12,022.64 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $7,762.47 Typical High $7,762.47 | Professional | None | $1,445.44 | $7,762.47 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,995.26 Typical High $4,365.16 | Professional | None | $1,412.54 | $1,995.26 | $4,365.16 |
Moda Health Setting Facility Modifier None Typical Low $2,344.23 Median $7,762.47 Typical High $11,220.18 | Facility | None | $2,344.23 | $7,762.47 | $11,220.18 |
Moda Health Setting Professional Modifier None Typical Low $1,584.89 Median $6,165.95 Typical High $8,709.64 | Professional | None | $1,584.89 | $6,165.95 | $8,709.64 |
Premera BCBS Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,888.44 | $5,888.44 | $5,888.44 |
Providence Setting Facility Modifier None Typical Low $7,943.28 Median $251,188.64 Typical High $346,736.85 | Facility | None | $7,943.28 | $251,188.64 | $346,736.85 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $2,041.74 Typical High $4,365.16 | Professional | None | $60.26 | $2,041.74 | $4,365.16 |
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 $1,380.38 Median $3,981.07 Typical High $9,120.11 | Professional | None | $1,380.38 | $3,981.07 | $9,120.11 |
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 $724.44 Median $3,890.45 Typical High $3,890.45 | Professional | 52 · Reduced service | $724.44 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $1,548.82 Typical High $1,548.82 | Professional | 53 · Discontinued | $288.40 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $5,888.44 Typical High $5,888.44 | Professional | 54 · Surgery only | $1,071.52 | $5,888.44 | $5,888.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $1,174.90 Typical High $1,174.90 | Professional | 55 · Aftercare only | $218.78 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $776.25 Typical High $776.25 | Professional | 56 · Pre-op care only | $144.54 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $5,495.41 Typical High $5,495.41 | Professional | 78 · Unplanned return to OR | $1,000.00 | $5,495.41 | $5,495.41 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $3,890.45 Typical High $3,890.45 | Professional | 52 · Reduced service | $794.33 | $3,890.45 | $3,890.45 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $1,548.82 Typical High $1,548.82 | Professional | 53 · Discontinued | $316.23 | $1,548.82 | $1,548.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $5,888.44 Typical High $5,888.44 | Professional | 54 · Surgery only | $1,202.26 | $5,888.44 | $5,888.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $1,174.90 Typical High $1,174.90 | Professional | 55 · Aftercare only | $239.88 | $1,174.90 | $1,174.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $776.25 Typical High $776.25 | Professional | 56 · Pre-op care only | $158.49 | $776.25 | $776.25 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $5,495.41 Typical High $5,495.41 | Professional | 78 · Unplanned return to OR | $1,122.02 | $5,495.41 | $5,495.41 |
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
$5,248
AK $5,248TX $240
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.